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Schlechter P, Hillmann M, Neufeld SAS. Gender, age, and longitudinal measurement invariance of child and adolescent depression scales: A systematic review. Clin Psychol Rev 2024; 113:102481. [PMID: 39168055 DOI: 10.1016/j.cpr.2024.102481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/20/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
Understanding developmental trajectories and gender differences in depressive symptoms is clinically relevant. Discerning true differences across gender, age groups, and time is based on the often-neglected premise of measurement invariance (MI) of child and adolescent depression scales. In this systematic review, we assessed available evidence for MI across gender, age groups, and time for depression scales validated in children and adolescents, in studies with at least one assessment under age 18. A literature search using Medline, PsychInfo, Scopus, Web of Science, and Google Scholar databases identified 42 studies that examined MI. MI of eleven scales was tested in 1-9 studies per scale. Conclusions are hampered by different factor solutions tested within some scales. All included questionnaires showed preliminary evidence for MI across gender. Across some studies, crying had higher factor loadings in females compared to males, indicating that crying may be differently related to depression across gender. MI evidence was preliminary in just four scales across time, mostly confined to ages 13-17. One study showed developmental conclusions differed when non-invariance is not accounted for in observed scores. Overall, evidence for MI in child and adolescent depression scales is currently limited.
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Affiliation(s)
- Pascal Schlechter
- Institute of Psychology, University of Münster, Germany; Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany; University of Cambridge, Department of Psychiatry, UK.
| | - Mona Hillmann
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
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Dennison CA, Shakeshaft A, Eyre O, Tilling K, Rice F, Thapar A. Investigating the neurodevelopmental correlates of early adolescent-onset emotional problems. J Affect Disord 2024; 364:212-220. [PMID: 39134151 DOI: 10.1016/j.jad.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/04/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Emotional problems (EPs) increase sharply after mid-adolescence. Earlier EPs are associated with poorer long-term outcomes, and their underlying mechanisms may differ to later-onset EPs. Given an established relationship between ADHD, autism, and later depression, we aimed to examine associations between neurodevelopmental conditions and correlates and early adolescent-onset EPs. METHODS Adolescents in two UK population cohorts, Avon Longitudinal Study of Parents and Children (ALSPAC) and Millennium Cohort Study (MCS), were included. Individuals scoring >6 on the Strengths and Difficulties Questionnaire (SDQ) emotional problems subscale between ages 11-14 were defined as having early adolescent-onset EP, whilst those scoring >6 for the first time at 16-25 were defined as having later-onset EP. We tested associations between early adolescent-onset EP (total cases = 887, controls = 19,582) and ICD-10/DSM-5 neurodevelopmental conditions and known correlates, including: sex, birth complications, low cognitive ability, special educational needs (SEND), and epilepsy. Analyses were conducted separately in ALSPAC and MCS then meta-analysed. RESULTS In the meta-analysis of both cohorts, early adolescent-onset EPs were associated with female sex and greater likelihood of low cognitive ability, SEND, autism, ADHD, and reading difficulties. Compared to later-onset EP, early adolescent-onset EPs were associated with male sex, low cognitive ability, SEND, epilepsy, ASD, ADHD, and reading difficulties. LIMITATIONS A clinical definition of depression/anxiety was available only in ALSPAC, instead we primarily defined EP via questionnaires, which capture a broader phenotype. CONCLUSIONS Individuals with early adolescent-onset EP are likely to have a co-occurring neurodevelopmental condition. Clinicians should consider assessing for neurodevelopmental conditions in young adolescents with EPs.
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Affiliation(s)
- Charlotte A Dennison
- Wolfson Centre for Young People's Mental Health, Cardiff University, UK; Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Amy Shakeshaft
- Wolfson Centre for Young People's Mental Health, Cardiff University, UK; Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Olga Eyre
- Wolfson Centre for Young People's Mental Health, Cardiff University, UK; Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, Bristol University, UK
| | - Frances Rice
- Wolfson Centre for Young People's Mental Health, Cardiff University, UK; Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Anita Thapar
- Wolfson Centre for Young People's Mental Health, Cardiff University, UK; Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK.
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Jamet C, Dubertret C, Le Strat Y, Tebeka S. Age of onset of major depressive episode and association with lifetime psychiatric disorders, health-related quality of life and impact of gender: A cross sectional and retrospective cohort study. J Affect Disord 2024; 363:300-309. [PMID: 39004313 DOI: 10.1016/j.jad.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/07/2024] [Accepted: 07/11/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To assess the long-term impact of the age of onset (AOO) of the first major depressive episode (MDE) according to 3 age groups and considering gender. METHODS Data were extracted from NESARC III, a representative U.S. SAMPLE We included 8053 participants with an MDE history in a cross-sectional and retrospective cohort study. We defined 3 AOO groups: childhood-onset (< 13 yo), adolescence-onset (13-18 yo), and adult-onset (> 18 yo). We compared sociodemographic characteristics, lifetime psychiatric disorders per DSM-5 criteria, and health-related quality of life (HRQOL) in each group and performed gender-stratified analyses. RESULTS Prevalence of childhood-onset MDE was 10.03 %, adolescence-onset was 14.12 %, and adult-onset was 75.85 %. Suicide attempts (AOR = 3.61; 95 % CI 2.90-4.50), anxiety disorders (AOR = 1.92; 95 % CI 1.62-2.27), and personality disorders (AOR = 3.08; 95 % CI 2.56-3.71) were more frequent in the childhood-onset than in the adult-onset one. Adolescence-onset group showed similar results. Physical Disability scale (p < 0.001) and Mental Disability scale (p < 0.001) were significantly lower in the childhood-onset group. Results were more nuanced in the adolescence-onset group. Women in childhood-onset and adolescence-onset groups had poorer outcomes than the adult-onset group. Differences were less pronounced in men. LIMITATIONS Recall and classification biases inherent to survey design. CONCLUSION Individuals, particularly women, who experienced their first MDE during childhood or adolescence exhibit higher lifetime psychiatric disorder prevalence and poorer HRQOL than those with adult-onset MDE. These findings highlight the importance of preventive measures, early diagnosis, and treatment of youth depression.
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Affiliation(s)
- Camille Jamet
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, 92700 Colombes, France; Université Paris Cité, Faculty of Medicine, Paris, France
| | - Caroline Dubertret
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, 92700 Colombes, France; Université Paris Cité, Faculty of Medicine, Paris, France; INSERM U1266, Centre for Psychiatry and Neurosciences, 102 rue de la Santé, 75014 Paris, France
| | - Yann Le Strat
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, 92700 Colombes, France; Université Paris Cité, Faculty of Medicine, Paris, France; INSERM U1266, Centre for Psychiatry and Neurosciences, 102 rue de la Santé, 75014 Paris, France
| | - Sarah Tebeka
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, 92700 Colombes, France; Université Paris Cité, Faculty of Medicine, Paris, France; INSERM U1266, Centre for Psychiatry and Neurosciences, 102 rue de la Santé, 75014 Paris, France.
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He P, Lu X, Zhong M, Weng H, Wang J, Zhang X, Jiang C, Geng F, Shi Y, Zhang G. Plasma alpha-trypsin inhibitor heavy chain 4 as an age-specific biomarker in the diagnosis and treatment of major depressive disorder. Front Psychiatry 2024; 15:1449202. [PMID: 39323962 PMCID: PMC11422199 DOI: 10.3389/fpsyt.2024.1449202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/26/2024] [Indexed: 09/27/2024] Open
Abstract
Background The diagnosis of major depressive disorder (MDD) mainly depends on subjective clinical symptoms, without an acceptable objective biomarker for the clinical application of MDD. Inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) showed a high specificity as biomarker for the diagnosis and treatment of MDD. The present study aimed to investigate differences in plasma ITIH4 in two different aged MDD patients and underlying pathological mechanisms of plasma ITIH4 in the occurrence and development of MDD. Methods Sixty-five adult MDD patients, 51 adolescent MDD patients, and 64 healthy controls (HCs) were included in the present study. A 14-days' antidepressive treatment was conducted in all MDD patients. Psychological assessments were performed and plasma ITIH4 and astrocyte-related markers were detected for all participants. Results (1) Plasma levels of ITIH4 in adult MDD patients were significantly higher than adolescent MDD patients and HCs, and significantly increased plasma ITIH4 levels was observed in adolescent MDD patients compared with HCs (2). There were positive correlations between plasma ITIH4 levels and 24-item Hamilton Depression Scale (HAMD-24) scores and plasma glial fibrillary acidic protein (GFAP) levels in MDD patients, however, plasma ITIH4 levels were significantly correlated with age just in adult MDD patients (3). Plasma ITIH4 showed area under the curve values of 0.824 and 0.729 to differentiate adult MDD patients and adolescent MDD patients from HCs, respectively (4). There was significant decrease in plasma levels of ITIH4 between before and after antidepressive treatment in adult MDD patients, but not in adolescent MDD patients (5). Changed value of ITIH4 levels were correlated with the changed value of GFAP levels and changed rate of HAMD-24 scores in adult MDD patients following antidepressive treatment. Conclusion Plasma ITIH4 may be potential plasma biomarkers of MDD with age-related specificity, which was associated with depressive symptoms astrocyte-related pathologic changes, and antidepressive treatment efficacy.
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Affiliation(s)
- Ping He
- Department of Neurosurgery Intensive Care Unit, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Xuefang Lu
- Department of Rehabilitation Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Mengmeng Zhong
- Department of Functional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Hui Weng
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Jialu Wang
- Department of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Xiaoxuan Zhang
- Department of Neurosurgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Chen Jiang
- Department of Neurosurgery Intensive Care Unit, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Feng Geng
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Yachen Shi
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
- Department of Interventional Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Gaojia Zhang
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei, China
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Zhang M, Jiang J, Peng W, Yang R, Liu Q, Li S, Li Y, Liu Q. A cross-sectional study of the association between physical activity and depressive symptoms among adolescents in southwest China stratified by parental absence: the mediating role of insomnia and the moderating role of resilience. BMJ Open 2024; 14:e079531. [PMID: 39260839 PMCID: PMC11409347 DOI: 10.1136/bmjopen-2023-079531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2024] Open
Abstract
OBJECTIVES This study explored the mechanisms by which physical activity was associated with depressive symptoms in multi-ethnic (Han, Yi and Tibetan) adolescents in southwest China. The mediating role of insomnia in the association of physical activity with depressive symptoms, the moderating role of resilience in this mediation model and the moderating role of parental absence in the moderated mediation model were also examined. DESIGN A cross-sectional survey. SETTING In southwest China (Sichuan Province and Tibet Autonomous Region). PARTICIPANTS 3195 adolescents from a school-based survey conducted between April and October 2020. METHODS There were 3143 valid samples in this study (47.2% males with mean age=12.88±1.68 years). Structural equation models were developed to estimate the direct and mediating effect, and the moderating effect. Multigroup comparison was performed to examine the differences and similarities of the moderated mediation model across three parental absence subgroups: (1) both parents present, (2) one parent absent and (3) both parents absent. RESULTS As hypothesised, physical activity was significantly and positively associated with the reduction of depressive symptoms in adolescents. Insomnia partially mediated the effect of physical activity on depressive symptoms. In addition, resilience moderated the direct and indirect effects of physical activity (through insomnia) on depressive symptoms. Finally, the multigroup comparison indicated the moderating effect of parental absence on the moderated mediation model. CONCLUSIONS Physical activity was associated with alleviating insomnia symptoms among adolescents, thus correlating with the improvement of their depressive symptoms. Resilience was associated with enhancing the beneficial effects of physical activity, further improving depressive symptoms among adolescents, especially those with both absent parents. It is evident that physical activity interventions should be further incorporated into public health programmes to foster the physical and mental health of left-behind adolescents in southwest China.
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Affiliation(s)
- Ming Zhang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China
| | - Jianjun Jiang
- Department of Palliative Care, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China
| | - Wei Peng
- Department of Palliative Care, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China
| | - Ruixi Yang
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China
| | - Qijiao Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China
| | - Shiying Li
- Department of Sociology and Psychology, Sichuan University School of Public Administration, Chengdu, Sichuan, China
| | - Yuchen Li
- Mental Health Center, Sichuan University, Chendu, Sichuan, China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Qiaolan Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China
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DelBello MP, Findling RL, Huss M, Necking O, Petersen ML, Schmidt SN, Rosen M. Vortioxetine in children and adolescents with major depressive disorder: 6-month and 18-month open-label, flexible-dose, long-term extension studies. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02560-1. [PMID: 39240359 DOI: 10.1007/s00787-024-02560-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 08/07/2024] [Indexed: 09/07/2024]
Abstract
Children and adolescents with severe or relapsing major depressive disorder (MDD) may require long-term antidepressant use, but safety and tolerability data on long-term treatment are limited. In a randomized, placebo-controlled trial in children and another in adolescents, vortioxetine and placebo groups showed improvement in MDD symptoms without statistically significant differences between groups. To gain insights on long-term safety and tolerability of vortioxetine in pediatric patients, participants from these two studies were enrolled in two long-term extension studies: 6 months (NCT02871297) followed by another 18 months (NCT03108625). Key safety measures included adverse events (AEs) and Columbia-Suicide Severity Rating Scale (C-SSRS); effectiveness measures included depression symptom severity, cognitive function, and overall functioning. Among the 662 patients in the 6-month extension, 61% experienced a treatment-emergent AE (TEAE), with the most common being nausea (20.8%); 2.1% had a serious AE (SAE), and 6% withdrew because of TEAEs. In the following 18-month extension (n = 94), 51% of patients experienced a TEAE, with the most common being headache (13.8%); no SAEs were reported. Based on the C-SSRS, 94% and 96% of patients reported no suicidal ideation or behavior in the 6- and 18-month studies, respectively. During the extension studies, patients continued to show improvement in depressive symptoms and cognitive and overall functioning, with > 50% of patients in remission at the end of each study, regardless of study treatment in the lead-in trial. Overall, vortioxetine remained well tolerated in pediatric patients with MDD who continued in the long-term extension studies with no observed increased risk in suicidal ideation.
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Affiliation(s)
- Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 260 Stetson Ave. Suite 3200, Cincinnati, Ohio, 45219, USA.
| | - Robert L Findling
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael Huss
- Department of Child and Adolescent Psychiatry, University Medicine of Gutenberg University, Mainz, Germany
| | - Oscar Necking
- Clinical Research, H. Lundbeck A/S, Copenhagen, Denmark
| | | | | | - Monika Rosen
- Clinical Research, H. Lundbeck A/S, Copenhagen, Denmark
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Liu C, Zhou R, Peng X, Chen X, Xia Z, Wei W, Zhu T, Chen G. The longitudinal study of the relationship between social participation pattern and depression symptoms in frail older adults. Front Psychiatry 2024; 15:1440641. [PMID: 39290302 PMCID: PMC11405299 DOI: 10.3389/fpsyt.2024.1440641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024] Open
Abstract
Background Mental health challenges are encountered by frail older adults as the population ages. The extant literature is scant regarding the correlation between depressive symptoms and social participation among frail older adults. Methods This study is based on an analysis of data from China Health and Retirement Longitudinal Study (CHARLS) participants aged 60 and older who are frail. A frailty index (FI) was developed for the purpose of assessing the frailty level of the participants. Additionally, latent class analysis (LCA) was employed to classify the participants' social engagement patterns in 2015 and 2018. The study used ordered logistic regression to examine the relationship between social participation type and depressive symptoms. We also used Latent Transition Analysis (LTA) methods to explore the impact of changes in social activity types on depressive symptoms after three years of follow-up in 2018. In addition, the response surface analysis (RSM) investigation explored the relationship among FI, depression, and social participation. Results A total of 4,384 participants completed the baseline survey; three years later, 3,483 were included in the follow-up cohort. The baseline survey indicates that female older adults in rural areas who are single, have lower incomes, shorter sleep durations, and lighter weights exhibited more severe depressive symptoms. Social participation patterns were categorized into five subgroups by LCA. The findings indicate that individuals classified as "board game enthusiasts" (OR, 0.62; 95% CI, 0.47-0.82) and those as "extensive social interaction" (OR,0.67; 95% CI, 0.49-0.90) have a significantly lower likelihood of developing depressive symptoms compared to the "socially isolated" group. We also discovered that "socially isolated" baseline participants who transitioned to the "helpful individual" group after three years had significantly greater depressed symptoms (OR, 1.56; 95% CI, 1.00-2.44). More social activity types and less FI are linked to lower depression in our study. Conclusion The results of the study emphasize the importance of social participation patterns and the number of social participation types in relation to the severity of depression among frail older adults individuals. This study's findings may provide important insights for addressing depressive symptoms in frail older adults person.
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Affiliation(s)
- Congqi Liu
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Ruihao Zhou
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Xilin Peng
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Xudong Chen
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Zhen Xia
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Wei Wei
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Zhu
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Guo Chen
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, China
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Faries E, Mabe LA, Franzen RL, Murtaza S, Nathani K, Ahmed B, Prokop L, Mohammed K, Ahmed AT. Interventional approaches to treatment resistant depression (DTR) in children and adolescents: A systematic review and meta-analysis. J Affect Disord 2024; 367:519-529. [PMID: 39226935 DOI: 10.1016/j.jad.2024.08.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 08/18/2024] [Accepted: 08/30/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is highly prevalent in youth. Conventional treatment paradigms primarily involve selective serotonin reuptake inhibitors (SSRIs) and psychotherapy, yet a significant proportion of this population exhibits treatment-resistant depression (TRD). In adults, interventional therapies like Electroconvulsive Therapy (ECT), repetitive Transcranial Magnetic Stimulation (rTMS), and ketamine have shown promise for TRD, but their comparative efficacy remains underexplored in Adolescent and pediatric population. This systematic review and meta-analysis aims to assess the relative effectiveness of ECT, rTMS, and ketamine in treating TRD among adolescents. METHODS Following PRISMA guidelines, we systematically searched databases for studies of ECT, rTMS, or ketamine for treatment-resistant depression in youth ages 10-24. Three reviewers independently screened for inclusion based on predefined criteria. Included observational and randomized controlled trials reported depression symptoms with measures like HDRS and MADRS in youth treated with ECT, rTMS, or ketamine. Two reviewers extracted data on interventions, patients, and depression symptom outcomes. Chance-adjusted inter-reviewer agreement was calculated. For meta-analysis, we pooled standardized mean differences (SMDs) in depression scores using random effects models and assessed heterogeneity with I2 statistics. RESULTS Meta-analysis of 10 observational studies examined SMD in depression scores for treatment resistant depression patients treated with ECT, ketamine, or rTMS. Patients treated with ECT had a significantly lower SMD of 1.99 (95 % CI 0.92-3.05, p < 0.001) compared to baseline. Patients treated with ketamine also had a significantly lower SMD of 1.58 (95 % CI 1.04-2.12, p < 0.001). Patients treated with rTMS had the lowest SMD of 2.79 (95 % CI 0.79-4.80, p = 0.006). There was no significant difference between the three groups overall (p > 0.05). Comparative analysis between ECT and ketamine found no significant difference in SMD (p = 0.387). Comparison of ECT versus rTMS found a significant difference in SMD favoring rTMS (p = 0.004). Comparison of ketamine versus rTMS suggested a potential difference in SMD favoring rTMS (p = 0.058). In summary, rTMS resulted in significantly larger reductions in depression scores than ECT, and potentially larger reductions than ketamine. CONCLUSIONS This meta-analysis illustrates the ability of rTMS, ECT, and ketamine to improve depression in youth. rTMS resulted in the largest improvements, highlighting its potential as a first-line treatment for pediatric treatment-resistant depression given its favorable side effect profile compared to ECT. Further research directly comparing these modalities is needed.
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Affiliation(s)
- Ethan Faries
- McGovern Medical School at UTHealth Houston, Houston, TX, USA.
| | - Landon A Mabe
- School of Medicine, Baylor College of Medicine, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | | | - Syed Murtaza
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Komal Nathani
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Burhan Ahmed
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA
| | - Khaled Mohammed
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ahmed T Ahmed
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA
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Austin AE, Frank M, Short NA. Adolescent Mental Health and Suicidal Behaviors in the Context of Expanded Supplemental Nutrition Assistance Program Eligibility. J Adolesc Health 2024; 75:435-441. [PMID: 39001749 DOI: 10.1016/j.jadohealth.2024.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/22/2024] [Accepted: 05/29/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE Food insecurity is a risk factor for poor mental health and suicidal behaviors among adolescents. Prior research shows that states with policies that expand Supplemental Nutrition Assistance Program (SNAP) eligibility have a lower prevalence of food insecurity. The primary aim of this study was to compare the prevalence of feelings of sadness or hopelessness, suicidal ideation, and suicide attempts among adolescents in states that had the asset test eliminated and the income limit increased for SNAP eligibility to adolescents in states that did not have either policy. METHODS Using 2013-2021 data from state Youth Risk Behavior Surveys (N = 855,119) and the SNAP Policy Database, we conducted log-binomial regression with generalized estimating equations and adjusted for confounders. RESULTS The prevalence of persistent feelings of sadness or hopelessness was similar among adolescents in states that had the asset test eliminated only and among adolescents in states that had both the asset test eliminated and the income limit increased (i.e., both policies) compared to adolescents in states that did not have either policy. While the prevalence of suicidal thoughts was similar among adolescents in states that had the asset test eliminated only compared to adolescents in states that did not have either policy, the prevalence of suicidal thoughts (prevalence ratio = 0.91, 95% CI 0.88, 0.94) and suicide attempts (prevalence ratio = 0.82, 95% CI 0.78, 0.86) was lower among adolescents in states that had both policies compared to adolescents in states that did not have either policy. DISCUSSION States with policies that expand SNAP eligibility have a lower prevalence of suicidal behaviors among adolescents.
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Affiliation(s)
- Anna E Austin
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Madeline Frank
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nicole A Short
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, Nevada
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Bore MC, Liu X, Huang X, Kendrick KM, Zhou B, Zhang J, Klugah-Brown B, Becker B. Common and separable neural alterations in adult and adolescent depression - Evidence from neuroimaging meta-analyses. Neurosci Biobehav Rev 2024; 164:105835. [PMID: 39084585 DOI: 10.1016/j.neubiorev.2024.105835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/25/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024]
Abstract
Depression is a highly prevalent and debilitating mental disorder that often begins in adolescence. However, it remains unclear whether adults and adolescents with depression exhibit common or distinct brain dysfunctions during reward processing. We aimed to identify common and separable neurofunctional alterations during receipt of rewards and brain structure in adolescents and adults with depression. A coordinate-based meta-analysis was employed using Seed-based d mapping with permutation of subject images (SDM-PSI). Compared with healthy controls, both age groups exhibited common activity decreases in the right striatum (putamen, caudate) and subgenual ACC. Adults with depression showed decreased reactivity in the right putamen and subgenual ACC, while adolescents with depression showed decreased activity in the left mid cingulate, right caudate but increased reactivity in the right postcentral gyrus. This meta-analysis revealed shared (caudate) and separable (putamen and mid cingulate cortex) reward-related alterations in adults and adolescents with depression. The findings suggest age-specific neurofunctional alterations and stress the importance of adolescent-specific interventions that target social functions.
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Affiliation(s)
- Mercy Chepngetich Bore
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiqin Liu
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China; The Xiaman Key Lab of Psychoradiology and Neuromodulation, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
| | - Keith M Kendrick
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Zhou
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jie Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Benjamin Klugah-Brown
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
| | - Benjamin Becker
- Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Department of Psychology, The University of Hong Kong, Hong Kong, China.
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11
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Jiang Y, Chen Y, Wei Y, Li S, Wang K, Cheng J. Integrative intrinsic brain activity and molecular analyses of the interaction between first-episode depression and age. J Affect Disord 2024; 367:129-136. [PMID: 39222854 DOI: 10.1016/j.jad.2024.08.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/11/2024] [Accepted: 08/29/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Numerous studies have underscored the presence of abnormal intrinsic neural activity (INA) in individuals with depression. However, recognizing that the age stage may influence the pathophysiology of depression, our study sought to delve into the interplay of depression and age on INA and molecular architecture. METHODS One hundred and thirty-eight first-episode depression patients and 120 healthy controls (HC) were recruited and underwent resting-state functional magnetic resonance imaging. The participants were stratified into four groups based on age. Utilizing amplitude of low-frequency fluctuation (ALFF) analyses, we employed an ANCOVA to compare INA patterns in four groups. Additionally, we conducted correlation analyses between ALFF and neurotransmitter maps to elucidate molecular underpinnings of INA abnormalities. RESULTS In comparison to adolescents with early-onset depression and adult HC, adult-onset depression exhibited increased ALFF in the right paracentral lobule. Conversely, early-onset depression, when contrasted with adolescent HC, displayed reduced ALFF in the right paracentral lobule. The interactive brain regions affected by ALFF alterations were associated with serotonergic, GABAergic, and opioid neurotransmitter systems. LIMITATIONS The present study was limited to its cross-sectional design. CONCLUSIONS This study illuminates an antagonistic effect of depression and age on brain activity in paracentral lobule and provides molecular underpinnings of the corresponding INA abnormalities related to key neurotransmitter systems. These insights may prove valuable in the development of neuromarkers for clinical intervention and treatment of depression.
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Affiliation(s)
- Yu Jiang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Ying Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Shuying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Kaiyu Wang
- MR Research China, GE Healthcare, Beijing 100000, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
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Yang H, Chen Y, Tao Q, Shi W, Tian Y, Wei Y, Li S, Zhang Y, Han S, Cheng J. Integrative molecular and structural neuroimaging analyses of the interaction between depression and age of onset: A multimodal magnetic resonance imaging study. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111052. [PMID: 38871019 DOI: 10.1016/j.pnpbp.2024.111052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/30/2024] [Accepted: 06/10/2024] [Indexed: 06/15/2024]
Abstract
Depression is a neurodevelopmental disorder that exhibits progressive gray matter volume (GMV) atrophy. Research indicates that brain development is influential in depression-induced GMV alterations. However, the interaction between depression and age of onset is not well understood by the underlying molecular and neuropathological mechanisms. Thus, 152 first-episode depression individuals and matched 130 healthy controls (HCs) were recruited to undergo T1-weighted high-resolution magnetic resonance imaging for this study. By two-way ANOVA, age and diagnosis were used as factors when analyzing the interaction of GMV in the participants. Then, spatial correlations between neurotransmitter maps and factor-related volume maps are established. Results illustrate a pronounced antagonistic interaction between depression and age of onset in the right insula, superior temporal gyrus, anterior cingulate gyrus, and orbitofrontal gyrus. Depression-caused reductions in GMV are mainly distributed in thalamic-limbic-cortical regions, regardless of age. For the main effect of age, adults exhibit brain atrophy in frontal, cerebellum, parietal, and temporal lobe structures. Cross-modal correlations showed that GMV changes in the interactive regions were linked with the serotonergic system and dopaminergic systems. Summarily, our results reveal the interaction between depression and age of onset in neurobiological mechanisms, which provide hints for future treatment of different ages of depression.
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Affiliation(s)
- Huiting Yang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Qiuying Tao
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Wenqing Shi
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Ya Tian
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Shuying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China.
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China.
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Belaire E, Mualla F, Ball L, Ma I, Berkey D, Chen W. Relationship of Social-Emotional Learning, Resilience, Psychological Well-Being, and Depressive Symptoms with Physical Activity in School-Aged Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1032. [PMID: 39201966 PMCID: PMC11352933 DOI: 10.3390/children11081032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/14/2024] [Accepted: 08/19/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND This study investigated the association of psychological well-being (PWB), resilience, depressive symptoms, and social-emotional learning (SEL) with physical activity (PA) in school-aged children. The objective was to understand how these psychosocial factors influence PA levels and identify gender-specific differences in these relationships. METHODS This cross-sectional study involved 534 fourth grade and sixth grade students from eight schools in the Midwest region of the United States, with data collected through a Qualtrics survey. Multiple linear regression models were used to analyze the data, with gender-specific analyses conducted to identify differences between boys and girls. RESULTS The models indicated that all psychosocial factors taken together are significantly associated with PA (F = 26.937, p < 0.001). Of the factors, PWB and resilience were associated with higher PA individually for the total sample (β = 0.383, p = 0.001; β = 0.146, p = 0.005). A gender-specific analysis revealed that all factors collectively were significantly associated with PA in boys and girls (F = 15.846, p < 0.001; F = 6.869, p < 0.001). Individually, PWB and resilience were significantly associated with PA in boys (β = 0.358, p = 0.001; β = 0.171, p = 0.013), while only PWB was significantly associated with PA in girls (β = -0.355, p = 0.001). CONCLUSIONS This study highlights the necessity of promoting resilience and psychological well-being through structured physical activities, aiming to reduce the risk of obesity and improve mental health among children. Future research should consider longitudinal designs and objective measures to further elucidate these relationships and inform effective educational strategies.
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Affiliation(s)
- Evan Belaire
- Physical Activity and Health Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; (E.B.); (F.M.); (L.B.); (I.M.)
| | - Fawzi Mualla
- Physical Activity and Health Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; (E.B.); (F.M.); (L.B.); (I.M.)
| | - Lucas Ball
- Physical Activity and Health Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; (E.B.); (F.M.); (L.B.); (I.M.)
| | - Iris Ma
- Physical Activity and Health Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; (E.B.); (F.M.); (L.B.); (I.M.)
| | - Debra Berkey
- Society of Health and Physical Education (SHAPE) Michigan, Lansing, MI 49056, USA;
| | - Weiyun Chen
- Physical Activity and Health Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA; (E.B.); (F.M.); (L.B.); (I.M.)
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14
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Kim J, Cho M. Path to Suicidality in Korean Adolescents: Mediating Role of Self-Esteem, Somatic Symptoms, and Self-Harm Amid Depressive Symptoms. Healthcare (Basel) 2024; 12:1662. [PMID: 39201219 PMCID: PMC11353305 DOI: 10.3390/healthcare12161662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/02/2024] Open
Abstract
This study explored the relationship between depressive symptoms and suicidality among community-dwelling adolescents aged 10-18 years, examining whether self-esteem, somatic symptoms, and self-harm mediate this relationship. Utilizing a pre-existing dataset from a nationwide adolescent mental health survey conducted in Korea in 2021, data were collected using several standardized self-administered instruments: the Korean version of Rosenberg's self-esteem scale, Korean Children's Somatization Inventory, Korean version of the Self-Harm Inventory, Mental Health Screening for Depressive Disorders, and Mental Health Screening for Suicide Risk. A path model was constructed and validated, followed by path analysis to assess the effects. Data from 6689 adolescents, including 5937 students and 752 out-of-school adolescents, revealed that 18.7% were in the suicidality group, 11.8% experienced depressive symptoms, 57.9% exhibited somatic symptoms, and 27.4% engaged in self-harm. Depressive symptoms had a positive direct effect on suicidality (β = 0.166, p < 0.001, 95% confidence interval = 0.159-0.172). Bootstrapping tests showed a statistically significant indirect effect of self-esteem, somatic symptoms, and self-harm on the relationship between depressive symptoms and suicidality (β = 0.021, 95% confidence interval = 0.013-0.029). Our findings suggest that self-esteem, somatic symptoms, and self-harm mediate the relationship between depressive symptoms and suicidality, and comprehensive mental health management strategies addressing these factors are recommended.
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Affiliation(s)
- Jiyeon Kim
- College of Nursing, Ewha Womans University, Seoul 03760, Republic of Korea;
| | - Myongsun Cho
- Department of Nursing, Gangneung-Wonju National University, Wonju 26403, Republic of Korea
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15
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Lin Y, Chen Z, He M, Zhou W, Wang L, Guo H, Huang K. The relationship between anxiety and depression in adolescent depression patients: The mediating effect of hope level and coping modes. Heliyon 2024; 10:e35466. [PMID: 39170457 PMCID: PMC11336736 DOI: 10.1016/j.heliyon.2024.e35466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/09/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
Background Adolescents diagnosed with depression are particularly susceptible to anxiety and depressive symptoms, this vulnerability often diminishes their future expectations and overall outlook on life. The objective of this research was to scrutinize the associated risk factors of adolescent depression and delineated the interplay between anxiety and depressive symptoms. Concurrently, it sought to ascertain the latent mediating effects of hope levels and coping strategies within this framework. Methods A mixed-methods research approach was employed. For the qualitative component, 18 adolescents with depression were interviewed following a semi-structured interview guide, with sessions audio-recorded. The data were subsequently transcribed and subjected to thematic content analysis. In the quantitative phase, a cross-sectional online survey was administered to 210 adolescents diagnosed with depression using Questionnaire Star, with data analysis performed using SPSS25.0 and AMOS 24.0. Results The qualitative analysis identified three major themes and nine categories as key risk factors influencing the onset of adolescent depression. Three major themes were generated: school factors, family factors, and other factors. Nine categories were generated: heavy academic load, strained peer, and teacher-student relationships; unstable family structures, internal familial conflicts, and high parental expectations; a strong sense of social isolation, insufficient sexual education, and prevalent suicidal ideation or attempts. A nurturing and supportive school environment significantly bolsters adolescents' sense of hope and coping abilities, while a warm and encouraging family setting effectively mitigates psychological stress. Conversely, heightened loneliness and the onset of suicidal ideation are frequently linked to diminished hope and the adoption of maladaptive coping strategies. Hence, to comprehensively understand the intricate interplay of these factors, this study concentrated on the levels of hope and coping mechanisms, investigating their potential mediating role in adolescent anxiety and depression. Quantitative analysis revealed a positive correlation between anxiety and depression (r = 0.767, p<0.01). Additionally, it was found that hope levels and coping strategies mediated the relationship between anxiety and depressive symptoms (β = -0.24-0.84 = 0.20, p < 0.001; β = 0.19-0.51 = -0.10, p < 0.01), with the mediating influence of hope levels being more significant than that of coping strategies. Conclusion Enhancing hope levels and fostering positive coping strategies are instrumental in aiding adolescents with depression to alleviate their anxiety and depressive symptoms. Moreover, this study underscored the importance of focusing on adolescents' mental health and providing them with emotional support, thereby increasing their hope levels and encouraging the adoption of positive coping mechanisms to effectively address their challenges.
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Affiliation(s)
- Yan Lin
- Department of Nursing, Xinxiang Medical University, Xinxiang, Henan, China
- Henan International Joint Laboratory of Recombinant Therapeutic Protein Expression System, Henan, China
| | - Zhihan Chen
- Department of Nursing, Xinxiang Medical University, Xinxiang, Henan, China
| | - Mengjiao He
- Department of Nursing, Xinxiang Medical University, Xinxiang, Henan, China
| | - Weiqing Zhou
- Department of Nursing, Xinxiang Medical University, Xinxiang, Henan, China
| | - Lina Wang
- Department of Nursing, Xinxiang Medical University, Xinxiang, Henan, China
| | - Hua Guo
- The Affiliated Central Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Kaizong Huang
- Department of Clinical Pharmacology Lab, Nanjing First Hospital, Nanjing Medical University, China
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Krempel R, Jarvers I, Ecker A, Schleicher D, Brunner R, Kandsperger S. Sleep quality and the cortisol and alpha-amylase awakening responses in adolescents with depressive disorders. BJPsych Open 2024; 10:e140. [PMID: 39103977 DOI: 10.1192/bjo.2024.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Depressive disorders in adolescents affect all aspects of life and impose a very large burden of disease. Sleep is frequently affected by depression and is crucial for facing challenges during development. One of the postulated reasons for depression-induced sleep disruption is dysregulation of the physiological stress system. AIMS To investigate the links of adolescent depressive disorders with subjective sleep quality, objective sleep quality, and the course of cortisol and alpha-amylase after awakening. METHOD We compared subjective sleep quality (via daily questionnaires) and objective sleep quality (via actigraphy measurement) of 35 adolescents with depressive disorders and 29 healthy controls over 7 consecutive days. In addition, saliva samples were collected on 3 days to examine cortisol and alpha-amylase patterns after awakening. RESULTS No significant differences in cortisol or alpha-amylase awakening responses were observed between participants with depressive disorders and healthy controls. We found severe reductions in subjective sleep quality in the depression group (Z = -5.19, P < 0.001, d = 1.80) and a prolonged actigraphy-measured sleep onset latency (Z = -2.42, P = 0.015, d = 0.64) compared with controls. Reductions in subjective sleep quality were partially correlated with objective sleep measures (sleep onset latency: r = -0.270, P = 0.004, sleep efficiency: r = 0.215, P = 0.017). CONCLUSIONS Sleep onset latency seems to aggravate depressive symptoms and to have an important role in perception of sleep quality. Adolescents with depressive disorders should be supported regarding the establishment of good sleep hygiene and avoiding activities that may impede falling asleep.
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Affiliation(s)
- Rebekka Krempel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Irina Jarvers
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Angelika Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Daniel Schleicher
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Romuald Brunner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Stephanie Kandsperger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
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Vestin M, Blomqvist I, Henje E, Dennhag I. Psychometric validation of the Montgomery-åsberg Depression Rating Scale - Youth (MADRS-Y) in a clinical sample. Nord J Psychiatry 2024; 78:525-532. [PMID: 38967988 DOI: 10.1080/08039488.2024.2374417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 06/14/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Depression in adolescence is a serious major global health problem with increasing rates of prevalence. Measures of depression that are valid for young people are clearly needed in clinical contexts. METHODS The study included 577 patients from child and adolescent psychiatry (n = 471) and primary care (n = 106) aged 12-22 years in Sweden (Mage=16.7 years; 76% female). The reliability and validity for Montgomery-Åsberg Depression Rating Scale - Youth (MADRS-Y) were investigated. To confirm the latent structure, we used a single-factor confirmatory factor analysis (CFA). A Kruskal-Wallis test was performed to test total score differences between diagnostic groups. Using Spearman's rho correlations, we examine whether single items in the MADRS-Y correlate with suicidal ideation measured by The Suicidal Ideation Questionnaire-JR (SIQ-JR). RESULTS The internal consistency using McDonald's coefficient omega was excellent. The CFA of the 12-item MADRS-Y supported a one factor structure. Evidence of convergent and discriminant validity was shown. There was a significant difference in MADRS-Y scores across diagnostic groups, with higher results for depressive disorders. A strong correlation with suicidal ideation was found for two items. CONCLUSIONS The results support MADRS-Y as a brief, reliable, and valid self-report questionnaire of depressive symptoms for young patients in a clinical setting.
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Affiliation(s)
- Magnus Vestin
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Ida Blomqvist
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Eva Henje
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Inga Dennhag
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
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Guan L, Liu R, Wang C, Fan Q, Zhou J, Wang Y, Feng Y, Liu J, Zhou Y, Wang G, Chen X. Abnormal resting-state functional connectivity in subregions of amygdala in adults and adolescents with major depressive disorder. BMC Psychiatry 2024; 24:540. [PMID: 39085839 PMCID: PMC11293025 DOI: 10.1186/s12888-024-05977-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The different symptoms of major depressive disorder (MDD) in adolescents compared to adults suggested there may be differences in the pathophysiology between adolescents and adults with MDD. However, despite the amygdala being considered critical in the pathophysiology, there was limited knowledge about the commonalities and differences in the resting-state functional connectivity (rsFC) of amygdala subregions in MDD patients of different age groups. METHODS In the current study, 65 adolescents (46 with MDD and 19 controls) and 91 adults (35 with MDD and 56 controls) were included. A seed-based functional connectivity analysis was performed for each of the amygdala subregions. A 2 × 2 ANOVA was used to analyze the main effect of age, diagnosis, and their interaction on the rsFC of each subregion. RESULTS A significant main effect of age was revealed in the rsFC of bilateral centromedial (CM) subregions and right laterobasal (LB) subregion with several brain regions in the limbic system and frontoparietal network. The significant main effect of diagnosis showed MDD patients of different ages showed higher connectivity than controls between the right LB and left middle frontal gyrus (MFG). CONCLUSIONS The rsFC of specific amygdala subregions with brain regions in the limbic system and frontoparietal network is affected by age, indicating a distinct amygdala connectivity profile in adolescents. The decreased rsFC between the right LB and the left MFG in adolescents and adults with MDD could serve as a diagnostic biomarker and a target of nonpharmacological treatment for MDD.
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Affiliation(s)
- Lin Guan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Rui Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Changshuo Wang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qingchen Fan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jingjing Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yun Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuan Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
- Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
- Beijing Anding Hospital, Capital Medical University, Beijing, China.
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19
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Yang X, Miao J, Huang Y, Li L, Zhuang G. Preventive and therapeutic effect of vitamin D on depression-like behavior in a mouse adolescent depression model and its association with BDNF protein expression. Front Psychiatry 2024; 15:1425681. [PMID: 39135986 PMCID: PMC11317463 DOI: 10.3389/fpsyt.2024.1425681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/05/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction Previous studies in different populations have shown that vitamin D supplementation may reduce depression levels. In adolescents, vitamin D deficiency has been identified as a factor contributing to the onset of depression. This study aimed to establish a model of adolescent depression in mice by using the scientific unpredictable chronic mild stress (UCMS) model and to preliminarily evaluate the effect of vitamin D on the occurrence and development of depression and whether it is related to the protein expression of the BDNF pathway. Methods The UCMS method was used to establish a model of adolescent depression in 4-week-old C57BL/6 male mice, randomly divided into five groups: Control group, Stress group, Stress+ low-dose group, Stress+ medium-dose group, Stress+ high-dose group. At the same time as chronic stress, the administration groups were given intramuscular injections of different doses of vitamin D. After 8 weeks, behavioral tests, including the forced swimming test (FST) and open field test (OFT), were performed on each group of mice, along with recording of indicators, blood vitamin D level detection, and brain tissue western blot analysis. Results The results showed a significant difference in vitamin D levels among mice in different groups after 8 weeks (P=0.012). The results of behavioral testing showed a significant difference in the static time of forced swimming among the groups (P<0.001). Compared with the UCMS group, the static time of mice with vitamin D injection was significantly reduced (P<0.001). The total number of times mice entered the central area, the total distance of movement, and the time spent in the central area significantly increased after vitamin D injection compared with the UCMS-only group (all P<0.001). There was no significant difference in the expression of BDNF in the brain tissues of experimental mice (P>0.05). Discussion In conclusion, in the mouse adolescent depression model, appropriate vitamin D supplementation can reduce the occurrence of stress-induced depression. Furthermore, vitamin D deficiency may also serve as a potential risk factor for depression.
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Affiliation(s)
- Xueping Yang
- Department of Psychology, The People’s Hospital of Liaoning Province, The people’s hospital of China Medical University, Shenyang, Liaoning, China
| | - Junxiao Miao
- Department of Psychology, The People’s Hospital of Liaoning Province, The people’s hospital of China Medical University, Shenyang, Liaoning, China
| | - Yinglin Huang
- Department of Psychiatry, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lili Li
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Gengsen Zhuang
- Department of Psychiatry and Mental Health, The Medical University of Dalian, Dalian, Liaoning, China
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20
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Pan B, Zhao C, Gong Y, Miao J, Zhang B, Li Y. Parent-Child Relationships: A Shield Against Maternal Depression in the Midst of Household Chaos. Psychol Res Behav Manag 2024; 17:2769-2781. [PMID: 39070069 PMCID: PMC11283830 DOI: 10.2147/prbm.s456739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024] Open
Abstract
Background Depression, a severe mental disorder, not only jeopardizes the health of mothers but also significantly negative impacts on families and their children. This study investigates the correlation between household chaos and maternal depression. Methods This study adopted a cross-sectional design and used the Confusion, Hubbub, and Order Scale, Dyadic Adjustment Scale, Parent-Child Relationship Scale, and Beck Depression Inventory to assess 1947 mothers of children in seven kindergartens in Shanghai, China. Results The findings revealed a significant positive correlation between household chaos, marital conflict, and maternal depression. Marital conflict also showed a significantly positively correlated with maternal depression. Marital conflict mediates the relationship between household chaos and maternal depression. Parent-child relationships moderated the direct effect of household chaos on maternal depression. When parent-child relationships were low, household chaos had a greater predictive effect on maternal depression. Conversely, when parent-child relationships were high, the predictive effect of household chaos on maternal depression was reduced. Conclusion This study reveals that parent-child relationships play a protective role in the impact of household chaos on maternal depression. This study significantly contributes to enriching the social support buffering model.
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Affiliation(s)
- Baocheng Pan
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Chengli Zhao
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Yizhao Gong
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Jiaxuan Miao
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
| | - Bingda Zhang
- College of Economics and Management, Shanghai Zhongqiao Vocational and Technical University, Shanghai, People’s Republic of China
| | - Yan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People’s Republic of China
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21
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Menculini G, Cinesi G, Scopetta F, Cardelli M, Caramanico G, Balducci PM, De Giorgi F, Moretti P, Tortorella A. Major challenges in youth psychopathology: treatment-resistant depression. A narrative review. Front Psychiatry 2024; 15:1417977. [PMID: 39056019 PMCID: PMC11269237 DOI: 10.3389/fpsyt.2024.1417977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
Major depressive disorder (MDD) represents a major health issue in adolescents and young adults, leading to high levels of disability and profoundly impacting overall functioning. The clinical presentation of MDD in this vulnerable age group may slightly differ from what can be observed in adult populations, and psychopharmacological strategies do not always lead to optimal response. Resistance to antidepressant treatment has a prevalence estimated around 40% in youths suffering from MDD and is associated with higher comorbidity rates and suicidality. Several factors, encompassing biological, environmental, and clinical features, may contribute to the emergence of treatment-resistant depression (TRD) in adolescents and young adults. Furthermore, TRD may underpin the presence of an unrecognized bipolar diathesis, increasing the overall complexity of the clinical picture and posing major differential diagnosis challenges in the clinical practice. After summarizing current evidence on epidemiological and clinical correlates of TRD in adolescents and young adults, the present review also provides an overview of possible treatment strategies, including novel fast-acting antidepressants. Despite these pharmacological agents are promising in this population, their usage is expected to rely on risk-benefit ratio and to be considered in the context of integrated models of care.
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Affiliation(s)
- Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Gianmarco Cinesi
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Francesca Scopetta
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Matteo Cardelli
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Guido Caramanico
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Pierfrancesco Maria Balducci
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Community Mental Health Center “CSM Terni”, Department of Psychiatry, Local Health Unit USL Umbria 2, Terni, Italy
| | - Filippo De Giorgi
- Division of Psychiatry, Clinical Psychology and Rehabilitation, General Hospital of Perugia, Perugia, Italy
| | - Patrizia Moretti
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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22
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Schlechter P, Rohde P, Seeley JR, Klein DN, Olino TM. Examining the influence of episode number and age of onset on individual depressive symptoms across episodes of major depression. J Psychiatr Res 2024; 175:405-410. [PMID: 38776861 DOI: 10.1016/j.jpsychires.2024.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
Major depression is characterized by an episodic course with symptom manifestations differing across episodes. Previous work has found that symptom presentation differs across age. However, studies of symptom presentation have largely focused on symptoms in individual episodes, requiring further investigation of longitudinal symptom change. This study explored the impact of the initial age of onset, the number of episodes, and age of onset of each episode on individual depressive symptoms, while accounting for episode severity. We used data from the Oregon Adolescent Depression Project (N = 629) examining participants with at least one major depressive episode, assessed by diagnostic interview, across a 15-year follow-up. Multilevel logistic regression models revealed that approximately 20-25% of the main effects were significant and some were qualified by cross-level interactions. However, only a few associations remained robust after correcting for multiple comparisons. Specifically, older initial age of onset was associated with fatigue, younger initial age of onset for the first episode was associated with suicidal ideation, and a lower episode number was associated with weight loss. These findings highlight potential initial age of onset and scar effects influencing symptom manifestation, but require replication.
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Affiliation(s)
| | | | | | | | - Thomas M Olino
- Department of Psychology & Neuroscience, Temple University, USA
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23
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Strekalova T, Radford-Smith D, Dunstan IK, Gorlova A, Svirin E, Sheveleva E, Burova A, Morozov S, Lyundup A, Berger G, Anthony DC, Walitza S. Omega-3 alleviates behavioral and molecular changes in a mouse model of stress-induced juvenile depression. Neurobiol Stress 2024; 31:100646. [PMID: 38912378 PMCID: PMC11190747 DOI: 10.1016/j.ynstr.2024.100646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/29/2024] [Accepted: 05/19/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Depression is increasingly diagnosed in adolescence, necessitating specific prevention and treatment methods. However, there is a lack of animal models mimicking juvenile depression. This study explores a novel model using ultrasound (US) stress in juvenile mice. Methods We employed the US stress model in one-month-old C57/BL6 mice, exposing them to alternating ultrasound frequencies (20-25 kHz and 25-45 kHz) for three weeks. These frequencies correspond to negative and neutral emotional states in rodents and can induce a depressive-like syndrome. Concurrently, mice received either an omega-3 food supplement (FS) containing eicosapentaenoic acid (EPA; 0.55 mg/kg/day) and docosahexaenoic acid (DHA; 0.55 mg/kg/day) or a vehicle. Post-stress, we evaluated anxiety- and depressive-like behaviors, blood corticosterone levels, brain expression of pro-inflammatory cytokines, and conducted metabolome analysis of brain, liver and blood plasma. Results US-exposed mice treated with vehicle exhibited decreased sucrose preference, a sign of anhedonia, a key feature of depression, increased anxiety-like behavior, elevated corticosterone levels, and enhanced TNF and IL-1β gene expression in the brain. In contrast, US-FS mice did not display these changes. Omega-3 supplementation also reduced anxiety-like behavior in non-stressed mice. Metabolomic analysis revealed US-induced changes in brain energy metabolism, with FS increasing brain sphingomyelin. Liver metabolism was affected by both US and FS, while plasma metabolome changes were exclusive to FS. Brain glucose levels correlated positively with activity in anxiety tests. Conclusion Chronic omega-3 intake counteracted depressive- and anxiety-like behaviors in a US model of juvenile depression in mice. These effects likely stem from the anti-inflammatory properties of the supplement, suggesting potential therapeutic applications in juvenile depression.
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Affiliation(s)
- Tatyana Strekalova
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
- Department of Pharmacology, Oxford University, Oxford, UK
| | | | | | - Anna Gorlova
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia
- RUDN University, 6 Miklukho-Maklaya Str, Moscow, Russia
| | - Evgeniy Svirin
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Elisaveta Sheveleva
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia
- Department of Normal Physiology, Sechenov Moscow State Medical University, Moscow, Russia
| | - Alisa Burova
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Sergey Morozov
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Aleksey Lyundup
- RUDN University, 6 Miklukho-Maklaya Str, Moscow, Russia
- Endocrinology Research Centre, Dmitry Ulyanov str. 19, Moscow, 117036, Russia
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zuerich, Zuerich, Switzerland
| | | | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zuerich, Zuerich, Switzerland
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24
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Jiao L, Chen T, Huang Y, Huang X. Effect analysis of repeated transcranial magnetic stimulation combined with fluoxetine in the treatment of first-episode adolescent depression. Front Psychiatry 2024; 15:1397706. [PMID: 38938464 PMCID: PMC11210588 DOI: 10.3389/fpsyt.2024.1397706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
Objectives This study aims to evaluate the efficacy of repeated transcranial magnetic stimulation (rTMS) combined with fluoxetine in enhancing the early antidepressant response in first-episode adolescent depression cases, providing insights for patient diagnosis and treatment. Methods One hundred and thirty-five adolescents experiencing their first depressive episode were randomly assigned to either a sham group treated with fluoxetine or to low or high repetitive transcranial magnetic stimulation (rTMS) groups receiving both rTMS and fluoxetine. Therapeutic effects were assessed by comparing changes in Hamilton Depression Scale (HAMD-17) scores, cognitive function scores from the Wisconsin Card Sorting Test (WCST), and Clinical Global Impression-improvement (CGI-I) scores, along with recording adverse reactions. Results The total effectiveness rate in the rTMS groups (Low, 95.56%; High, 97.78%) was significantly higher than in the Sham rTMS group (80%) (F = 11.15, P<0.0001). Post-treatment, not only the Low but also the High rTMS group exhibited more significant reductions in HAMD-17 (Low, 21.05; High, 21.45) and CGI-I scores (Low, 3.44; High, 3.60) compared to the Sham rTMS group (HAMD-17, 16.05; CGI-I, 2.57) (two weeks: F = 7.889, P = 0.0006; four weeks: F = 15.900, P<0.0001). Additionally, the two rTMS groups exhibited fewer erroneous responses and persistent errors in the WCST and completed more WCST categorizations than the Sham rTMS group. There was no significant difference in adverse reaction rates between the groups (F=4.421, P=0.0794). Conclusions The combination of fluoxetine with rTMS demonstrates enhanced therapeutic effectiveness in treating adolescent depression, effectively controlling disease progression, reducing depressive symptoms, and improving cognitive function, making it a valuable clinical approach.
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Affiliation(s)
- Long Jiao
- Department of Psychology, The First Affiliated Hospital of Anhui Medical University, Heifei, China
- Department of Child Psychology, Anhui Provincial Children’s Hospital, Heifei, China
| | - Tingting Chen
- Laboratory of Medical Test, Hefei Technology College, Heifei, China
| | - Yuanyuan Huang
- Department of Child Psychology, Anhui Provincial Children’s Hospital, Heifei, China
| | - Xiaoqin Huang
- Department of Psychology, The First Affiliated Hospital of Anhui Medical University, Heifei, China
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Su L, Guo P, Guo X, He Z, Zhao Y, Zong Y, Li J, Chen W, DU R. Paeoniflorin alleviates depression by inhibiting the activation of NLRP3 inflammasome via promoting mitochondrial autophagy. Chin J Nat Med 2024; 22:515-529. [PMID: 38906599 DOI: 10.1016/s1875-5364(24)60654-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Indexed: 06/23/2024]
Abstract
Depression ranks among the most common neuropsychiatric disorders globally. Current studies examining the roles of inflammation and mitochondrial autophagy in the antidepressant efficacy of paeoniflorin (PF) are sparse. This study aimed to elucidate PF's antidepressant mechanism by promoting autophagy and inhibiting NLRP3 inflammasome activation using chronic unpredictable mild stimulation (CUMS)-induced C57BL/6 mouse models in vivo and corticosterone (CORT)-induced HT22 cell models in vitro. Results demonstrated that PF enhanced the viability of HT22 cells following CORT exposure, restored mitochondrial membrane potential (MMP), reduced reactive oxygen species accumulation, increased LC3 fluorescence intensity, and suppressed inflammatory cytokine secretion and inflammation activation. Additionally, PF ameliorated depressive behaviors induced by CUMS and improved damage in hippocampal neurons. It also reduced the expression of NLRP3, ASC, Caspase-1, IL-1β, and the assembly of the NLRP3 inflammasome. Moreover, PF upregulated the expression of autophagy-related proteins in the hippocampus, facilitating the clearance of damaged mitochondria and enhancing autophagy. The role of autophagy in PF's antidepressant effects was further confirmed through the use of the autophagy inhibitor 3-methyladenine (3-MA), which reduced the efficacy of PF. In conclusion, PF effectively improved depressive behaviors in CUMS-induced mice and reduced NLRP3-mediated inflammation both in vivo and in vitro, likely via the induction of autophagy.
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Affiliation(s)
- Lili Su
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China.
| | - Pengli Guo
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China
| | - Xiangjuan Guo
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China
| | - Zhongmei He
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China
| | - Yan Zhao
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China
| | - Ying Zong
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China
| | - Jianming Li
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China
| | - Weijia Chen
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China.
| | - Rui DU
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun 130118, China; Jilin Provincial Engineering Research Center for Efficient Breeding and Product Development of Sika Deer, Changchun 130118, China; Key Laboratory of Animal Production and Product Quality and Security, Ministry of Education, Ministry of National Education, Changchun 130118, China.
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26
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Villa M, Martínez-Vega M, Silva L, Muneta-Arrate I, Gómez-Soria A, Muguruza C, Del Pozo A, de Hoz-Rivera M, Romero A, Callado LF, Casarejos MJ, Martínez-Orgado J. Effects of cannabidiol in post-stroke mood disorders in neonatal rats. Pediatr Res 2024; 95:1783-1790. [PMID: 38360979 DOI: 10.1038/s41390-024-03077-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Neonatal rats can manifest post-stroke mood disorders (PSMD) following middle cerebral artery occlusion (MCAO). We investigated whether cannabidiol (CBD) neuroprotection, previously demonstrated in neonatal rats after MCAO, includes prevention of PSMD development. METHODS Seven-day-old Wistar rats (P7) underwent MCAO and received either vehicle or 5 mg/kg CBD treatment. Brain damage was quantified by MRI, and neurobehavioral and histological (TUNEL) studies were performed at P14 and P37. PSMD were assessed using the tail suspension test, forced swimming test, and open field tests. The dopaminergic system was evaluated by quantifying dopaminergic neurons (TH+) in the Ventral Tegmental Area (VTA), measuring brain dopamine (DA) concentration and DA transporter expression, and assessing the expression and function D2 receptors (D2R) through [35S]GTPγS binding. Animals without MCAO served as controls. RESULTS CBD reduced MCAO-induced brain damage and improved motor performance. At P14, MCAO induced depressive-like behavior, characterized by reduced TH+ cell population and DA levels, which CBD did not prevent. However, CBD ameliorated hyperactivity observed at P37, preventing increased DA concentration by restoring D2R function. CONCLUSIONS These findings confirm the development of PSMD following MCAO in neonatal rats and highlight CBD as a neuroprotective agent capable of long-term functional normalization of the dopaminergic system post-MCAO. IMPACT MCAO in neonatal rats led to post-stroke mood disorders consisting in a depression-like picture in the medium term evolving towards long-term hyperactivity, associated with an alteration of the dopaminergic system. The administration of CBD after MCAO did not prevent the development of depressive-like behavior, but reduced long-term hyperactivity, normalizing dopamine receptor function. These data point to the importance of considering the development of depression-like symptoms after neonatal stroke, a well-known complication after stroke in adults. Our work confirms the interest of CBD as a possible treatment for neonatal stroke.
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Affiliation(s)
- María Villa
- Biomedical Research Foundation, Hospital Clínico San Calos-IdISSC, Madrid, Spain
| | - María Martínez-Vega
- Biomedical Research Foundation, Hospital Clínico San Calos-IdISSC, Madrid, Spain
| | - Laura Silva
- Biomedical Research Foundation, Hospital Clínico San Calos-IdISSC, Madrid, Spain
| | - Itziar Muneta-Arrate
- Department of Pharmacology, University of the Basque Country, UPV/EHU, Bizkaia, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Bizkaia, Spain
| | - Ana Gómez-Soria
- Servicio de Neurobiología-Investigación, Hospital Ramón y Cajal, Madrid, Spain
| | - Carolina Muguruza
- Department of Pharmacology, University of the Basque Country, UPV/EHU, Bizkaia, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Bizkaia, Spain
| | - Aarón Del Pozo
- Biomedical Research Foundation, Hospital Clínico San Calos-IdISSC, Madrid, Spain
| | - María de Hoz-Rivera
- Biomedical Research Foundation, Hospital Clínico San Calos-IdISSC, Madrid, Spain
| | - Angela Romero
- Biomedical Research Foundation, Hospital Clínico San Calos-IdISSC, Madrid, Spain
| | - Luis F Callado
- Department of Pharmacology, University of the Basque Country, UPV/EHU, Bizkaia, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Bizkaia, Spain
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | | | - José Martínez-Orgado
- Biomedical Research Foundation, Hospital Clínico San Calos-IdISSC, Madrid, Spain.
- Department of Neonatology, Hospital Clínico San Calos-IdISSC, Madrid, Spain.
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Zhu L, Wang Y, Li J, Zhou H, Li N, Wang Y. Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases. Front Public Health 2024; 12:1381273. [PMID: 38841667 PMCID: PMC11151855 DOI: 10.3389/fpubh.2024.1381273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction It remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases. Methods Data were collected from the China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan-Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality. Results Out of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09-1.33]). An increased rate was observed for 55-64 years old (HR = 1.23 [95% CI, 1.03-1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18-1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30-1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61-2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00-1.40]), diabetes (HR = 1.41[95% CI, 1.02-1.95]), and arthritis (HR = 1.29 [95% CI, 1.09-1.51]). Conclusion Depressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.
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Affiliation(s)
- Lan Zhu
- School of Education and Psychology, Key Research Institute of Humanities and Social Sciences of State Ethnic Affairs Commission, and Research Centre of Sichuan Minzu Education Development, Southwest Minzu University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yixi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Huan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ningxiu Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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Shell AL, Crawford CA, Cyders MA, Hirsh AT, Stewart JC. Depressive disorder subtypes, depressive symptom clusters, and risk of obesity and diabetes: A systematic review. J Affect Disord 2024; 353:70-89. [PMID: 38432462 DOI: 10.1016/j.jad.2024.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Overlapping but divided literatures suggest certain depression facets may pose greater obesity and diabetes risk than others. Our objectives were to integrate the major depressive disorder (MDD) subtype and depressive symptom cluster literatures and to clarify which facets are associated with the greatest cardiometabolic disease risk. METHODS We conducted a systematic review of published studies examining associations of ≥2 MDD subtypes or symptom clusters with obesity or diabetes risk outcomes. We report which facets the literature is "in favor" of (i.e., having the strongest or most consistent results). RESULTS Forty-five articles were included. Of the MDD subtype-obesity risk studies, 14 were in favor of atypical MDD, and 8 showed similar or null associations across subtypes. Of the symptom cluster-obesity risk studies, 5 were in favor of the somatic cluster, 1 was in favor of other clusters, and 5 were similar or null. Of the MDD subtype-diabetes risk studies, 7 were in favor of atypical MDD, 3 were in favor of other subtypes, and 5 were similar or null. Of the symptom cluster-diabetes risk studies, 7 were in favor of the somatic cluster, and 5 were similar or null. LIMITATIONS Limitations in study design, sample selection, variable measurement, and analytic approach in these literatures apply to this review. CONCLUSIONS Atypical MDD and the somatic cluster are most consistently associated with obesity and diabetes risk. Future research is needed to establish directionality and causality. Identifying the depression facets conferring the greatest risk could improve cardiometabolic disease risk stratification and prevention programs.
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Affiliation(s)
- Aubrey L Shell
- Department of Psychiatry, Indiana University Health, United States of America
| | | | - Melissa A Cyders
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Indianapolis, United States of America.
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Jin Y, Wang Y, Liu S, Niu S, Sun H, Liu Y, Liu N. The Relationship Between Stressful Life Events and Depressive Symptoms in College Students: mediation by Parenting Style and Gender's Moderating Effect. Psychol Res Behav Manag 2024; 17:1975-1989. [PMID: 38766317 PMCID: PMC11100962 DOI: 10.2147/prbm.s461164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/01/2024] [Indexed: 05/22/2024] Open
Abstract
Aim Stressful life events have a significant impact on the mental health of college students. Depression, as a prevalent psychological issue, has garnered attention in the field of college student mental health and is closely linked to it. Additionally, parenting style is identified as an important factor influencing the development of college students' mental health. Therefore, this study aims to explore the relationship between these three factors. Methods A total of 8079 first-year college students from two medical universities in Shandong Province, China were surveyed. The Beck Depression Inventory was utilized to evaluate depressive symptoms among the college students, while the Adolescent Self-rating Life Events Checklist and the Egna Minnen Beträfande Uppfostran were employed to gather data. Subsequently, the SPSS macro program PROCESS was utilized to analyze both the mediating and moderating effects. All statistical analyses were conducted using SPSS 26.0. Results The study found a detection rate of 6.3% for depressive symptoms among college students. The correlation analysis of this study showed that the stressful life events of college students were significantly positively correlated with depressive symptoms (r=0.261, p< 0.01). Each dimension of parenting style was associated with depressive symptoms in different degrees and directions. At the same time, parenting styles of all sizes play a partial mediating role between stressful life events and depressive symptoms in college students, gender plays a crucial regulatory role in this mediation. Conclusion Stressful life events experienced by college students have a significant impact on their mental health. Early intervention through positive parenting styles from parents may prove to be beneficial in promoting the development of good mental health among college students.
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Affiliation(s)
- Yan Jin
- School of Clinical Medicine, Jining Medical University, Jining, Shandong, 272002, People’s Republic of China
| | - Yiju Wang
- School of Mental Health, Jining Medical University, Jining, Shandong, 272002, People’s Republic of China
| | - Shusen Liu
- School of Pharmacy, Harbin University of Commerce, Harbin, Heilongjiang, 150076, People’s Republic of China
| | - Sifang Niu
- School of Public Health, Binzhou Medical University, Binzhou, Shandong, 264003, People’s Republic of China
| | - Hao Sun
- School of Clinical Medicine, Jining Medical University, Jining, Shandong, 272002, People’s Republic of China
| | - Yan Liu
- School of Public Health, Jining Medical University, Jining, Shandong, 272002, People’s Republic of China
| | - Ning Liu
- School of Basic Medicine, Jining Medical University, Jining, Shandong, 272067, People’s Republic of China
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Gao M, Song Y, Liu Y, Miao Y, Guo Y, Chai H. TNF-α/TNFR1 activated astrocytes exacerbate depression-like behavior in CUMS mice. Cell Death Discov 2024; 10:220. [PMID: 38710713 DOI: 10.1038/s41420-024-01987-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024] Open
Abstract
Neuroinflammation is considered to be a significant mechanism contributing to depression. Several studies have reported that A1 astrocytes were highly prevalent in human neuroinflammatory and neurodegenerative diseases. However, the precise mechanism by which A1 astrocytes contribute to depression remains unclear. Clinical studies have suggested a correlation between TNF-α, an activator of A1 astrocytes, and the severity of depression. Based on these findings, we hypothesized that TNF-α might worsen depression by activating A1 astrocytes. Our previous studies indicated that Rhodomyrtone (Rho) has the potential to improve depression-like behavior in mice. However, the exact mechanism for this effect has not been fully elucidated. Importantly, it was reported that Rho alleviated skin inflammation in a mouse model of psoriasis by inhibiting the expression of TNF-α. Based on this finding, we hypothesized that rhodomyrtone may exert antidepressant effects by modulating the TNF-α pathway. However, further research is required to investigate and validate these hypotheses, shedding light on the relationships between neuroinflammation, A1 astrocytes, TNF-α, and depression. By obtaining a deeper understanding of the underlying mechanisms, these findings could lead to the development of novel antidepressant strategies that target the TNF-α pathway in the context of neuroinflammation. In vivo, based on the established chronic unpredictable mild stress (CUMS) mouse depression model, we characterized the mechanism of TNF-α and Rho during depression by using several behavioral assays, adeno-associated virus(AAV) transfection, western blotting, immunofluorescence, and other experimental methods. In vitro, we characterized the effect of Rho on inflammation in TNF-α-treated primary astrocytes. TNFR1 expression was significantly increased in the hippocampus of depression-like mice, with increased astrocytes activation and neuronal apoptosis. These processes were further enhanced with increasing levels of TNF-α in the cerebrospinal fluid of mice. However, this process was attenuated by knockdown of TNFR1 and infliximab (Inf; a TNF-α antagonist). Injection of rhodomyrtone decreased the expressions of TNFR1 and TNF-α, resulting in significant improvements in mouse depression-like behaviors and reduction of astrocyte activation. TNF-α could be involved in the pathophysiological process of depression, through mediating astrocytes activation by binding to TNFR1. By blocking this pathway, Rho may be a novel antidepressant.
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Affiliation(s)
- Mengjiao Gao
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China
| | - Yu Song
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China
| | - Yaqi Liu
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Yuqing Miao
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China
| | - Yanwu Guo
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
| | - Huihui Chai
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Institutes of Brain Science, Shanghai Key Laboratory of Brain Function and Regeneration, Institute of Neurosurgery, MOE Frontiers Center for Brain Science, Shanghai, 200040, China.
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Wang J, Fan L, Teng T, Wu H, Liu X, Yin B, Li X, Jiang Y, Zhao J, Wu Q, Guo Y, Zhou X, Xie P. Adolescent male rats show altered gut microbiota composition associated with depressive-like behavior after chronic unpredictable mild stress: Differences from adult rats. J Psychiatr Res 2024; 173:183-191. [PMID: 38547740 DOI: 10.1016/j.jpsychires.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/11/2024] [Accepted: 03/21/2024] [Indexed: 04/17/2024]
Abstract
Accumulating evidence reveals the metabolism and neurotransmitter systems are different in major depressive disorder (MDD) between adolescent and adult patients; however, much is still unknown from the gut microbiome perspective. To minimize confounding factors such as geographical location, ethnicity, diet, and drugs, we investigated the gut microbial differences between adolescent and adult male Sprague-Dawley rats. We exposed the adolescent rats to chronic unpredictable mild stress (CUMS) for 3 weeks and assessed their behavior using the sucrose preference test (SPT), open field test (OFT), and forced swimming test (FST). We collected and sequenced fecal samples after the behavioral tests and compared them with our previous data on adult rats. Both adolescent and adult CUMS rats exhibited reduced sucrose preference in SPT, reduced total distance in OFT, and increased immobility time in FST. Moreover, compared to their respective controls, the adolescent CUMS rats had distinct amplicon sequence variants (ASVs) mainly in the Muribaculaceae family, Bacteroidetes phylum, while the adult CUMS rats had those in the Lachnospiraceae family, Firmicutes phylum. In the adolescent group, the Muribaculaceae negatively correlated with FST and positively correlated with SPT and OFT. In the adult group, the different genera in the Lachnospiraceae showed opposite correlations with FST. Furthermore, the adolescent CUMS rats showed disrupted microbial functions, such as "Xenobiotics biodegradation and metabolism" and "Immune system", while the adult CUMS rats did not. These results confirmed the gut microbiota differences between adolescent and adult rats after CUMS modeling and provided new insight into the age-related influence on depression models.
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Affiliation(s)
- Jie Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Fan
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Teng Teng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongyan Wu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueer Liu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bangmin Yin
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanliang Jiang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianting Zhao
- Department of Neurology, Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical College, Xinxiang, China
| | - Qingyuan Wu
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Yi Guo
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Peng Xie
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Higson-Sweeney N, Cooper K, Dunn BD, Loades ME. "I'm always going to be tired": a qualitative exploration of adolescents' experiences of fatigue in depression. Eur Child Adolesc Psychiatry 2024; 33:1369-1381. [PMID: 37300578 PMCID: PMC10257178 DOI: 10.1007/s00787-023-02243-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
Adolescent depression is a prevalent and disabling condition, but current psychological treatments are only moderately effective. One way to enhance outcomes is to further our understanding of adolescent depression and improve our capacity to target the most frequently reported and problematic symptoms. A common but often neglected symptom of depression is fatigue, which is associated with considerable impairment and has the potential to interfere with adolescents' engagement in psychological therapies. Despite this, the experience of fatigue in adolescent depression and how we target it in treatment is currently poorly understood. Therefore, we aimed to explore adolescents' experiences and understandings of fatigue in depression, recruiting from clinical and community settings. Semi-structured interviews were conducted with 19 UK-based adolescents aged 14-18 years old with elevated symptoms of depression. Using reflexive thematic analysis, three themes were generated. Fatigue is a complex concept explored adolescents' understanding of fatigue as a dynamic, multifaceted symptom which had mental and physical components. Trapped in a cycle of fatigue considered the complex and reciprocal relationship between fatigue and other depressive symptoms, and the subsequent impact of limited energy on engagement with everyday activities. Finally, stigma as a barrier to help-seeking highlighted how adolescents were reluctant to seek help due to experienced stigma and the perception that fatigue was not a serious enough symptom. Findings from this study suggest that fatigue should be viewed as a psychological as well as somatic symptom of depression, with implications regarding the identification and treatment of fatigue in depression in routine clinical practice.
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Affiliation(s)
- Nina Higson-Sweeney
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
| | - Kate Cooper
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Barnaby D Dunn
- Mood Disorders Centre, University of Exeter, Exeter, EX4 4QG, UK
| | - Maria E Loades
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
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Kim KM, Lee KH, Kim H, Kim O, Kim JW. Symptom clusters in adolescent depression and differential responses of clusters to pharmacologic treatment. J Psychiatr Res 2024; 172:59-65. [PMID: 38364553 DOI: 10.1016/j.jpsychires.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/20/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Symptoms of depression in adolescents are widely variable, but they are often interactive and clustered. The analysis of interactions and clusters among individual symptoms may help predict treatment outcomes. We aimed to determine clusters of individual symptoms in adolescent depression and their changes in the response to pharmacological treatment. METHOD A total of 95 adolescents, aged 12-17 years, with major depressive disorder were included. Participants were treated with escitalopram, and depressive symptoms were assessed at baseline (V1) and 1, 2, 4, 6, and 8 weeks (V6). The severity of depression was assessed using the Children's Depression Rating Scale-Revised. To construct network and clustering structures among symptoms, the Gaussian graphical model and Exploratory Graph Analysis with the tuning parameter to minimize the extended Bayesian information criterion were adopted. RESULTS Exploratory Graph Analysis revealed that symptoms of depression comprised four clusters: impaired activity, somatic concerns, subjective mood, and observed affect. The main effect of visit with decreased symptom severity was significant in all four clusters; however, the degree of symptom improvement differed among the four clusters. The effect size of score differences from V1 to V6 was the highest in the subjective mood (Cohen's d = 1.075), and lowest in impaired activity (d = 0.501) clusters. CONCLUSION The present study identified four symptom clusters associated with adolescent depression and their differential changes related to antidepressant treatment. This finding suggests that escitalopram was the most effective at improving subjective mood among different clusters. However, other therapeutic modalities may be needed to improve other clusters of symptoms, consequently leading to increased overall improvement of depression in adolescents.
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Affiliation(s)
- Kyoung Min Kim
- Department of Psychiatry, College of Medicine, Dankook University, Cheonan, Republic of Korea; Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Haebin Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ok Kim
- Department of Psychology, Graduate School of Dankook University, Cheonan, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Resch F, Parzer P. [Anxiety and depression in adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:374-382. [PMID: 38456934 PMCID: PMC10995088 DOI: 10.1007/s00103-024-03849-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Abstract
Anxiety and depression among young people had already increased in the years before the COVID-19 pandemic and then experienced a significant increase again during the pandemic. In this article the different clinical forms of expression of these emotional syndromes are presented in detail and the developmental paths of a combination of both disorders are also explained. Even subclinical forms of anxiety and depression already have clear clinical implications and impair the developmental tasks of adolescence. The "avolitional depression" (depression with severe drive disorders) is mentioned as a special form. Pathogenetic building blocks-from genetic vulnerability to psychosocial stressors-come up for discussion in light of the fact that anxiety and depression are about twice as common in adolescent females as in males. The embedding of the disorders in current events shows the special importance of the self-reflective emotion of shame in the adolescent development process. The scarcity and dysfunctionality of emotional dialogue between significant caregivers and children must be cautioned against. Its role in adolescents' self-regulation and affect regulation should not be underestimated. Finally, an overview of the most important therapeutic measures for anxiety and depression in adolescence is presented.
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Affiliation(s)
- Franz Resch
- Klinik für Kinder und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Blumenstraße 8, 69115, Heidelberg, Deutschland.
| | - Peter Parzer
- Klinik für Kinder und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Blumenstraße 8, 69115, Heidelberg, Deutschland
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Liu L, Yang X, Yang C, Tian Y, Li W, Xia L, Liu H. Associations between insomnia symptoms and inflammatory cytokines in adolescents with first-episode and recurrent major depressive disorder. J Affect Disord 2024; 350:110-117. [PMID: 38220096 DOI: 10.1016/j.jad.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/04/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Insomnia symptoms are often associated with increased levels of inflammatory biomarkers. However, such associations have not been adequately explored in adolescents with major depressive disorder (MDD). This study aimed to examine the associations between insomnia symptoms with inflammatory cytokines in adolescents with first-episode and recurrent MDD. METHODS From January to December 2021, this study included 164 adolescents with MDD and 76 healthy controls (HCs). The Center for Epidemiological Studies Depression Scale (CES-D) and the Insomnia Severity Index Scale (ISI) were used to assess depressive and insomnia symptoms, respectively. Also, plasma levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17 A and tumor necrosis factor-α (TNF-α) were measured. RESULTS The prevalence of mild, moderate and severe insomnia in adolescents with MDD was 40.24 %, 36.59 % and 6.71 %, respectively. The patients had higher levels of IL-1β, IL-6 and TNF-α than HCs (all p < 0.05). ISI score was positively correlated with CES-D score and levels of IL-1β, IL-6 and TNF-α in first-episode patients but not in recurrent patients. A further multivariate stepwise linear regression analysis showed that ISI score was independently associated with CES-D score (beta = 0.523, t = 5.833, p < 0.001) and TNF-α levels (beta = 0.254, t = 2.832, p = 0.006). LIMITATIONS The cross-sectional design leads to failure to make causal inferences. CONCLUSION Insomnia symptoms are common in adolescents with MDD and associated with elevated levels of inflammatory cytokines in first-episode patients. The findings suggest that inflammatory cytokines may relate to the pathogenesis of insomnia symptoms in adolescents with MDD, but further longitudinal studies are needed to explore the causal association between insomnia symptoms and inflammatory cytokines in MDD.
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Affiliation(s)
- Lewei Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Xiaoxue Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Cheng Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Yinghan Tian
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Wenzheng Li
- Department of Psychiatry, Hefei Fourth People's Hospital, Hefei 230000, Anhui Province, China
| | - Lei Xia
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China.
| | - Huanzhong Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China.
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Yin B, Cai Y, Teng T, Wang X, Liu X, Li X, Wang J, Wu H, He Y, Ren F, Kou T, Zhu ZJ, Zhou X. Identifying plasma metabolic characteristics of major depressive disorder, bipolar disorder, and schizophrenia in adolescents. Transl Psychiatry 2024; 14:163. [PMID: 38531835 DOI: 10.1038/s41398-024-02886-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024] Open
Abstract
Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) are classified as major mental disorders and together account for the second-highest global disease burden, and half of these patients experience symptom onset in adolescence. Several studies have reported both similar and unique features regarding the risk factors and clinical symptoms of these three disorders. However, it is still unclear whether these disorders have similar or unique metabolic characteristics in adolescents. We conducted a metabolomics analysis of plasma samples from adolescent healthy controls (HCs) and patients with MDD, BD, and SCZ. We identified differentially expressed metabolites between patients and HCs. Based on the differentially expressed metabolites, correlation analysis, metabolic pathway analysis, and potential diagnostic biomarker identification were conducted for disorders and HCs. Our results showed significant changes in plasma metabolism between patients with these mental disorders and HCs; the most distinct changes were observed in SCZ patients. Moreover, the metabolic differences in BD patients shared features with those in both MDD and SCZ, although the BD metabolic profile was closer to that of MDD than to SCZ. Additionally, we identified the metabolites responsible for the similar and unique metabolic characteristics in multiple metabolic pathways. The similar significant differences among the three disorders were found in fatty acid, steroid-hormone, purine, nicotinate, glutamate, tryptophan, arginine, and proline metabolism. Interestingly, we found unique characteristics of significantly altered glycolysis, glycerophospholipid, and sphingolipid metabolism in SCZ; lysine, cysteine, and methionine metabolism in MDD and BD; and phenylalanine, tyrosine, and aspartate metabolism in SCZ and BD. Finally, we identified five panels of potential diagnostic biomarkers for MDD-HC, BD-HC, SCZ-HC, MDD-SCZ, and BD-SCZ comparisons. Our findings suggest that metabolic characteristics in plasma vary across psychiatric disorders and that critical metabolites provide new clues regarding molecular mechanisms in these three psychiatric disorders.
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Affiliation(s)
- Bangmin Yin
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuping Cai
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai, China
| | - Teng Teng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaolin Wang
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueer Liu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongyan Wu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqian He
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fandong Ren
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai, China
| | - Tianzhang Kou
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai, China
| | - Zheng-Jiang Zhu
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai, China.
- Shanghai Key Laboratory of Aging Studies, Shanghai, China.
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Strouphauer E, Valenzuela-Flores C, Minhajuddin A, Slater H, Riddle DB, Pinciotti CM, Guzick AG, Hettema JM, Tonarelli S, Soutullo CA, Elmore JS, Gushanas K, Wakefield S, Goodman WK, Trivedi MH, Storch EA, Cervin M. The clinical presentation of major depressive disorder in youth with co-occurring obsessive-compulsive disorder. J Affect Disord 2024; 349:349-357. [PMID: 38199393 DOI: 10.1016/j.jad.2024.01.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is common in youth and among the most frequent comorbid disorders in pediatric obsessive-compulsive disorder (OCD), but it is unclear whether the presence of OCD affects the symptom presentation of MDD in youth. METHODS A sample of youth with OCD and MDD (n = 124) and a sample of youth with MDD but no OCD (n = 673) completed the Patient Health Questionnaire for Adolescents (PHQ-A). The overall and symptom-level presentation of MDD were examined using group comparisons and network analysis. RESULTS Youth with MDD and OCD, compared to those with MDD and no OCD, had more severe MDD (Cohen's d = 0.39) and more reported moderate to severe depression (75 % vs 61 %). When accounting for demographic variables and the overall severity of MDD, those with comorbid OCD reported lower levels of anhedonia and more severe difficulties with psychomotor retardation/agitation. No significant differences in the interconnections among symptoms emerged. LIMITATIONS Data were cross-sectional and self-reported, gold standard diagnostic tools were not used to assess OCD, and the sample size for the group with MDD and OCD was relatively small yielding low statistical power for network analysis. CONCLUSIONS Youth with MDD and OCD have more severe MDD than those with MDD and no OCD and they experience more psychomotor issues and less anhedonia, which may relate to the behavioral activation characteristic of OCD.
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Affiliation(s)
| | | | - Abu Minhajuddin
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA; Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Holli Slater
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David B Riddle
- College of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Andrew G Guzick
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John M Hettema
- Department of Psychiatry and Behavioral Sciences, Texas A&M Health Sciences Center, Bryan, TX, USA
| | - Silvina Tonarelli
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Cesar A Soutullo
- UT Health Houston, Louis A. Faillace MD Department of Psychiatry and Behavioral Sciences, Houston, TX, USA
| | - Joshua S Elmore
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kimberly Gushanas
- Department of Psychiatry, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Sarah Wakefield
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Wayne K Goodman
- College of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Eric A Storch
- College of Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Matti Cervin
- Department of Clinical Sciences, Lund University, Lund, Sweden
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Zwolińska W, Bilska K, Tarhonska K, Reszka E, Skibińska M, Pytlińska N, Słopień A, Dmitrzak-Węglarz M. Biomarkers of Depression among Adolescent Girls: BDNF and Epigenetics. Int J Mol Sci 2024; 25:3281. [PMID: 38542252 PMCID: PMC10970207 DOI: 10.3390/ijms25063281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 04/04/2024] Open
Abstract
Alterations in brain-derived neurotrophic factor (BDNF) expression have been suggested to mediate the influence of environmental factors on the emergence of depression through epigenetic modifications. However, research on this subject in the developmental population is lacking and the pathophysiology of adolescent depression remains unclear. We aimed to investigate the alterations in BDNF expression and global DNA methylation in depression among adolescent girls. Thirty female inpatients with the initial diagnosis of depression were assessed before and after the period of antidepressant treatment and compared with thirty age-matched healthy controls. The assessment involved BDNF and proBDNF serum levels, the BDNF gene exon IV promoter methylation, and global DNA methylation. The methylation level in the BDNF gene exon IV promoter was significantly lower in the studied group compared with the control and correlated negatively with the severity of depression. The test distinguished the studied group from the controls with a sensitivity of 37% and specificity of 90%. The differences were no longer present after the period of antidepressant treatment. No differences in the global DNA methylation, BDNF, and proBDNF levels were found. We concluded that decreased methylation in the BDNF exon IV promoter could be considered as a biomarker of a depression state among adolescent girls.
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Affiliation(s)
- Weronika Zwolińska
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland; (W.Z.); (N.P.); (A.S.)
| | - Karolina Bilska
- Department of Psychiatric Genetics, Medical Biology Center, Poznan University of Medical Sciences, Rokietnicka St. 8, 60-806 Poznan, Poland; (K.B.); (M.S.)
| | - Kateryna Tarhonska
- Department of Translational Research, Nofer Institute of Occupational Medicine, 91-348 Łódź, Poland; (K.T.); (E.R.)
| | - Edyta Reszka
- Department of Translational Research, Nofer Institute of Occupational Medicine, 91-348 Łódź, Poland; (K.T.); (E.R.)
| | - Maria Skibińska
- Department of Psychiatric Genetics, Medical Biology Center, Poznan University of Medical Sciences, Rokietnicka St. 8, 60-806 Poznan, Poland; (K.B.); (M.S.)
| | - Natalia Pytlińska
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland; (W.Z.); (N.P.); (A.S.)
| | - Agnieszka Słopień
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland; (W.Z.); (N.P.); (A.S.)
| | - Monika Dmitrzak-Węglarz
- Department of Psychiatric Genetics, Medical Biology Center, Poznan University of Medical Sciences, Rokietnicka St. 8, 60-806 Poznan, Poland; (K.B.); (M.S.)
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Cui L, Li S, Wang S, Wu X, Liu Y, Yu W, Wang Y, Tang Y, Xia M, Li B. Major depressive disorder: hypothesis, mechanism, prevention and treatment. Signal Transduct Target Ther 2024; 9:30. [PMID: 38331979 PMCID: PMC10853571 DOI: 10.1038/s41392-024-01738-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/24/2023] [Accepted: 12/28/2023] [Indexed: 02/10/2024] Open
Abstract
Worldwide, the incidence of major depressive disorder (MDD) is increasing annually, resulting in greater economic and social burdens. Moreover, the pathological mechanisms of MDD and the mechanisms underlying the effects of pharmacological treatments for MDD are complex and unclear, and additional diagnostic and therapeutic strategies for MDD still are needed. The currently widely accepted theories of MDD pathogenesis include the neurotransmitter and receptor hypothesis, hypothalamic-pituitary-adrenal (HPA) axis hypothesis, cytokine hypothesis, neuroplasticity hypothesis and systemic influence hypothesis, but these hypothesis cannot completely explain the pathological mechanism of MDD. Even it is still hard to adopt only one hypothesis to completely reveal the pathogenesis of MDD, thus in recent years, great progress has been made in elucidating the roles of multiple organ interactions in the pathogenesis MDD and identifying novel therapeutic approaches and multitarget modulatory strategies, further revealing the disease features of MDD. Furthermore, some newly discovered potential pharmacological targets and newly studied antidepressants have attracted widespread attention, some reagents have even been approved for clinical treatment and some novel therapeutic methods such as phototherapy and acupuncture have been discovered to have effective improvement for the depressive symptoms. In this work, we comprehensively summarize the latest research on the pathogenesis and diagnosis of MDD, preventive approaches and therapeutic medicines, as well as the related clinical trials.
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Affiliation(s)
- Lulu Cui
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Shu Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Siman Wang
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Xiafang Wu
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Yingyu Liu
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Weiyang Yu
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Yijun Wang
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Yong Tang
- International Joint Research Centre on Purinergic Signalling/Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education/School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine/Acupuncture and Chronobiology Key Laboratory of Sichuan Province, Chengdu, China
| | - Maosheng Xia
- Department of Orthopaedics, The First Hospital, China Medical University, Shenyang, China.
| | - Baoman Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China.
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China.
- China Medical University Centre of Forensic Investigation, Shenyang, China.
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Long Y, Li X, Cao H, Zhang M, Lu B, Huang Y, Liu M, Xu M, Liu Z, Yan C, Sui J, Ouyang X, Zhou X. Common and distinct functional brain network abnormalities in adolescent, early-middle adult, and late adult major depressive disorders. Psychol Med 2024; 54:582-591. [PMID: 37553976 DOI: 10.1017/s0033291723002234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
BACKGROUND The age-related heterogeneity in major depressive disorder (MDD) has received significant attention. However, the neural mechanisms underlying such heterogeneity still need further investigation. This study aimed to explore the common and distinct functional brain abnormalities across different age groups of MDD patients from a large-sample, multicenter analysis. METHODS The analyzed sample consisted of a total of 1238 individuals including 617 MDD patients (108 adolescents, 12-17 years old; 411 early-middle adults, 18-54 years old; and 98 late adults, > = 55 years old) and 621 demographically matched healthy controls (60 adolescents, 449 early-middle adults, and 112 late adults). MDD-related abnormalities in brain functional connectivity (FC) patterns were investigated in each age group separately and using the whole pooled sample, respectively. RESULTS We found shared FC reductions among the sensorimotor, visual, and auditory networks across all three age groups of MDD patients. Furthermore, adolescent patients uniquely exhibited increased sensorimotor-subcortical FC; early-middle adult patients uniquely exhibited decreased visual-subcortical FC; and late adult patients uniquely exhibited wide FC reductions within the subcortical, default-mode, cingulo-opercular, and attention networks. Analysis of covariance models using the whole pooled sample further revealed: (1) significant main effects of age group on FCs within most brain networks, suggesting that they are decreased with aging; and (2) a significant age group × MDD diagnosis interaction on FC within the default-mode network, which may be reflective of an accelerated aging-related decline in default-mode FCs. CONCLUSIONS To summarize, these findings may deepen our understanding of the age-related biological and clinical heterogeneity in MDD.
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Affiliation(s)
- Yicheng Long
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Manqi Zhang
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Bing Lu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Huang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mengqi Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Xu
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zhening Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chaogan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jing Sui
- IDG/McGovern Institute for Brain Research, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Xuan Ouyang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Cui Z, Xue H, Liu H, Liu F, Feng S, Chen H, Huang C, Wang J, Liu D. A latent class analysis of depressive symptoms among rural Chinese adolescents and their association with psychological resilience. Prev Med Rep 2024; 38:102625. [PMID: 38375174 PMCID: PMC10874837 DOI: 10.1016/j.pmedr.2024.102625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Numerous studies have demonstrated the heterogeneity of depressive symptoms, but few studies have focused on the heterogeneity of depressive symptoms among rural Chinese adolescents. In November to December 2022, multistage sampling was employed to administer questionnaires to 1,816 rural adolescents aged 11-19 years from six schools in Henan Province, China. Depressive symptoms were measured using the Chinese version of the Children's Depression Inventory Scale. Latent class analysis (LCA) was utilized to identify subgroups of depressive symptoms. The investigation of subgroup characteristics and associated factors was conducted through χ2 tests, ANOVA, and multinomial logistic regression analyses. The findings revealed a 24.24 % detection rate of depressive symptoms among Chinese rural adolescents. LCA analysis of responses to the 27 items in the Depressive Symptoms Scale led to the classification of depressive symptoms into four subgroups based on severity: "no depressive symptoms group" (22.5 %), a "low depressive symptoms group" (35.7 %), a "transition group" (31.6 %), and a "high depressive symptoms group" (10.2 %). Gender, grade level, academic performance, academic stress, family environment, and level of psychological resilience are associated factors for subgroups of depressive symptoms among rural adolescents. There should be increased training of rural educators to enable early recognition of depressive characteristics and risk factors, facilitating targeted prevention and intervention strategies.
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Affiliation(s)
- Zhenxiang Cui
- The College of Nursing and Health of Zhengzhou University, Henan, Zhengzhou, China
| | - Huijuan Xue
- The College of Nursing and Health of Zhengzhou University, Henan, Zhengzhou, China
| | - Haoran Liu
- School of Stomatology, Zhengzhou University, Henan, Zhengzhou, China
| | - Fan Liu
- The College of Nursing and Health of Zhengzhou University, Henan, Zhengzhou, China
| | - Siyuan Feng
- The College of Nursing and Health of Zhengzhou University, Henan, Zhengzhou, China
| | - Hui Chen
- The First Affiliated Hospital of Henan University of Chinese Medicine, Henan, Zhengzhou, China
| | - Caihui Huang
- The College of Nursing and Health of Zhengzhou University, Henan, Zhengzhou, China
| | - Jingjing Wang
- The College of Nursing and Health of Zhengzhou University, Henan, Zhengzhou, China
| | - Dongling Liu
- The College of Nursing and Health of Zhengzhou University, Henan, Zhengzhou, China
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Strojny P, Żuber M, Strojny A. The interplay between mental health and dosage for gaming disorder risk: a brief report. Sci Rep 2024; 14:1257. [PMID: 38218991 PMCID: PMC10787743 DOI: 10.1038/s41598-024-51568-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/06/2024] [Indexed: 01/15/2024] Open
Abstract
The relationship between gaming time and gaming disorder can be moderated by other variables. This study aimed to test the moderating role of mental health. Participants (N = 461) were recruited online. Gaming time was a statistically significant predictor of gaming disorder risk, with an explained variance of 3.3%. The goodness of fit of the model that took into account both moderators (anxiety and depression) improved to 13.9%. The interaction between gaming time and both moderators was significant. The results showed that depression and anxiety acted as moderators of the dosage effect, possibly by amplifying the gratification of playing games and thus contributing to the development of gaming disorder. It may be important in practise, as it seems to place the mental health at the right place, namely among risk factors that can contribute to gaming disorder in combination with a key trigger, which is gaming.
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Affiliation(s)
- Paweł Strojny
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Ul. Stanisława Łojasiewicza 4, 30-348, Kraków, Poland.
| | - Magdalena Żuber
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Ul. Stanisława Łojasiewicza 4, 30-348, Kraków, Poland
| | - Agnieszka Strojny
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Ul. Stanisława Łojasiewicza 4, 30-348, Kraków, Poland
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Zhang L, Liu H, Zheng Y. Editorial: Exploration of major depressive disorder among children and adolescents: from pathogenesis to intervention. Front Psychiatry 2024; 14:1350201. [PMID: 38264631 PMCID: PMC10804449 DOI: 10.3389/fpsyt.2023.1350201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
- Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yi Zheng
- Beijing Anding Hospital, Capital Medical University, Beijing Key Laboratory of Mental Disorders, Beijing, China
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Rust-Overman S, Hoying J, Sinnott L, Zeno R, Overcash J. Enhancing Pediatric Mental Health Care in an Outpatient Primary Care Setting Using the Keep Your Children/Yourself Safe and Secure (KySS) Program: A Multidisciplinary Quality Improvement Project. J Pediatr Health Care 2024; 38:5-12. [PMID: 37804306 DOI: 10.1016/j.pedhc.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION This project aimed to enhance access to pediatric mental primary health care. METHOD The Keep Your Children/Yourself Safe and Secure (KySS) training was offered to a multidisciplinary team at a Federally Qualified Health Clinic in the Midwest United States. Confidence was measured using the Healthcare Provider Confidence Scale (HPCS). Frequencies of visits and mental health referrals were compared preintervention/postintervention. HPCS scores were compared using Wilcoxon rank-sum and Cohen's d. RESULTS Referrals in 2022 were greater than in 2020 but less than in 2021 (p = .25). The total number of visits declined from 431 in 2021 to 385 in 2022. HPCS (n = 9) scores trended higher following the KySS Program in prescribing and general positive beliefs. DISCUSSION Referrals to mental health providers increased, although not significantly. The number of mental health visits varied between 2020-2022. Provider confidence was not significantly affected, whereas beliefs in prescribing did increase significantly. More work is necessary to understand the impact of delivery to a multidisciplinary team.
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Zhang Z, Yang Y, Kong W, Huang S, Tan Y, Huang S, Zhang M, Lu H, Li Y, Li X, Liu S, Wen Y, Shang D. A Bibliometric and Visual Analysis of Single Nucleotide Polymorphism Studies in Depression. Curr Neuropharmacol 2024; 22:302-322. [PMID: 37581520 PMCID: PMC10788886 DOI: 10.2174/1570159x21666230815125430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/30/2022] [Accepted: 02/10/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Genetic polymorphism has been proven to have an important association with depression, which can influence the risk of developing depression, the efficacy of medications, and adverse effects via metabolic and neurological pathways. Nonetheless, aspects of the association between single nucleotide polymorphisms and depression have not been systematically investigated by bibliometric analysis. OBJECTIVE The aim of this study was to analyze the current status and trends of single nucleotide polymorphism research on depression through bibliometric and visual analysis. METHODS The Web of Science Core Collection was used to retrieve 10,043 articles that were published between 1998 and 2021. CiteSpace (6.1 R4) was used to perform collaborative network analysis, co-citation analysis, co-occurrence analysis, and citation burst detection. RESULTS The most productive and co-cited journals were the Journal of Affective Disorders and Biological Psychiatry, respectively, and an analysis of the references showed that the most recent research focused on the largest thematic cluster, "5-HT", reflecting the important research base in this area. "CYP2D6" has been in the spotlight since its emergence in 2009 and has become a research hotspot since its outbreak in 2019. However, "BDNF ", "COMT ", "older adults", "loci", and "DNA methylation" are also the new frontier of research, and some of them are currently in the process of exploration. CONCLUSION These findings offer a useful perspective on existing research and potential future approaches in the study of the association between single nucleotide polymorphisms and depression, which may assist researchers in selecting appropriate collaborators or journals.
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Affiliation(s)
- Zi Zhang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Ye Yang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Wan Kong
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Shanqing Huang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Yaqian Tan
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Shanshan Huang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Ming Zhang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Haoyang Lu
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Yuhua Li
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Xiaolin Li
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Shujing Liu
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Yuguan Wen
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Dewei Shang
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
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Tao Y, Zou X, Tang Q, Hou W, Wang S, Ma Z, Liu G, Liu X. Mapping network connection and direction between anxiety and depression symptoms across the early, middle, and late adolescents: Insights from a large Chinese sample. J Psychiatr Res 2024; 169:174-183. [PMID: 38039692 DOI: 10.1016/j.jpsychires.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 08/18/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
Depression and anxiety are two mental disorders prevailing among adolescents. However, issues regarding the trajectory of depression and anxiety are still controversial on both the disease and symptom dimensions. The novel method of network analysis was used to provide insight into the symptom dimension. 20,544 adolescents (female = 10,743, 52.3%) aged between 14 and 24 years (age mean ± sd = 16.9 ± 2.94) were divided into three subgroups according to age so that the course of depression and anxiety could be traced. Network analysis and the Bayesian network model were used in the current study. The results indicated that uncontrollable worry - excessive worry was the most significant edge for all adolescents, whereas concentration - motor had the highest edge weights for early adolescents, and anhedonia - energy was the most critical pairwise symptom for middle and late adolescents. Irritability can bridge anxiety and depression in the early and middle stages of adolescence, while suicide plays a bridging role in the early and late stages of adolescence. Restlessness and guilt can bridge anxiety and depression in middle- and late-stage adolescents, and feeling afraid plays a unique role in middle-stage adolescents. Except for sad mood, which can trigger middle adolescents' anxiety and depression, the other three subgroups were mainly triggered by nervousness. In addition, all results in our current study were shown to be stable and accurate. In treatment, targeting central and triggering symptoms at different stages of adolescence may be critical to alleviating the comorbidity of anxiety and depression.
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Affiliation(s)
- Yanqiang Tao
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Xinyuan Zou
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Qihui Tang
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Wenxin Hou
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Shujian Wang
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Zijuan Ma
- School of Psychology, South China Normal University, Guangzhou, 510631, China.
| | - Gang Liu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
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Piątkowska-Chmiel I, Krawiec P, Ziętara KJ, Pawłowski P, Samardakiewicz M, Pac-Kożuchowska E, Herbet M. The Impact of Chronic Stress Related to COVID-19 on Eating Behaviors and the Risk of Obesity in Children and Adolescents. Nutrients 2023; 16:54. [PMID: 38201884 PMCID: PMC10780384 DOI: 10.3390/nu16010054] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
During the COVID-19 pandemic, an increase in the incidence of overweight and obesity in children was observed. It appears that unhealthy food choices, an unbalanced diet, and a sedentary lifestyle, as well as experiencing stress related to the pandemic, may be contributing to this disturbing trend. Chronic stress is a significant factor contributing to eating disorders and obesity in youngsters, involving medical, molecular, and psychological elements. Individuals under chronic stress often focus on appearance and weight, leading to negative body image and disrupted relationships with food, resulting in unhealthy eating behaviors. Chronic stress also impacts hormonal balance, reducing the satiety hormone leptin and elevating the appetite-stimulating hormone ghrelin, fostering increased hunger and uncontrolled snacking. Two systems, the hypothalamic-pituitary-adrenal axis and the sympathetic system with the adrenal medulla, are activated in response to stress, causing impaired secretion of noradrenaline and cortisol. Stress-related obesity mechanisms encompass oxidative stress, neuroinflammation, insulin resistance, and neurohormonal and neurotransmission disorders. Stress induces insulin resistance, elevating obesity risk by disrupting blood sugar regulation and fat storage. Stress also affects the gut microbiome, potentially influencing chronic inflammation and metabolic processes linked to obesity. In conclusion, chronic stress is a multifaceted risk factor for eating disorders and obesity in children, necessitating a comprehensive understanding of effective preventive and intervention strategies amid the escalating prevalence of childhood overweight and obesity.
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Affiliation(s)
- Iwona Piątkowska-Chmiel
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8b Street, 20-090 Lublin, Poland;
| | - Paulina Krawiec
- Department of Paediatrics and Gastroenterology, Medical University of Lublin, Al. Racławickie 1 Street, 20-059 Lublin, Poland; (P.K.); (E.P.-K.)
| | - Karolina Joanna Ziętara
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (K.J.Z.); (P.P.)
| | - Piotr Pawłowski
- Student Scientific Association at the Department of Psychology, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (K.J.Z.); (P.P.)
| | - Marzena Samardakiewicz
- Department of Psychology, Psychosocial Aspects of Medicine, Medical University of Lublin, Chodźki 7 Street, 20-093 Lublin, Poland;
| | - Elżbieta Pac-Kożuchowska
- Department of Paediatrics and Gastroenterology, Medical University of Lublin, Al. Racławickie 1 Street, 20-059 Lublin, Poland; (P.K.); (E.P.-K.)
| | - Mariola Herbet
- Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8b Street, 20-090 Lublin, Poland;
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Hodgson CG, Bonifay W, Yang W, Herman KC. Establishing the measurement precision of the patient health questionnaire in an adolescent sample. J Affect Disord 2023; 342:76-84. [PMID: 37708980 DOI: 10.1016/j.jad.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Technically sound measures are necessary for accurately identifying youth at risk for depression, but many studies rely on classical test theory metrics or adult samples to evaluate measures. This study examined the use of the PHQ-8, a common and freely available pediatric depression screener, in an adolescent sample using item response theory (IRT). METHODS Secondary analyses were conducted on data from a study conducted in Midwestern middle schools in which 1224 youth completed the PHQ-8 as part of a battery of surveys. Polytomous IRT analyses (a Graded Response Model) were used to evaluate the PHQ-8. Items were examined for their ability to distinguish between respondents of different latent depression severity and for differential item functioning (DIF) across demographic categories. RESULTS All PHQ-8 items had adequate discriminative abilities. Items measuring anhedonia and psychomotor disturbances performed relatively poorly, and items measuring somatic symptoms (appetite and sleep) were most informative when respondents endorsed extreme response options ("not at all" or "nearly every day"). No DIF was found across grade level or race, but several items were flagged for DIF by gender and student income level. LIMITATIONS These results might not be generalizable to a broader youth population due to administration setting and the unique demographic characteristics of this sample (76.0 % African American). CONCLUSIONS Tools such as the PHQ-8 are appropriate to quickly screen for depression in adolescents, but further scrutiny of adolescent response patterns is warranted. Future research should examine items measuring anhedonia and psychomotor and somatic disturbances in adolescents.
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Affiliation(s)
| | - Wes Bonifay
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA
| | - Wenxi Yang
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA.
| | - Keith C Herman
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA
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Xu H, Yang Z, Liu D, Yu C, Zhao Y, Yang J, Su Y, Jiang Y, Lu Q. Mediating effect of physical sub-health in the association of sugar-sweetened beverages consumption with depressive symptoms in Chinese college students: A structural equation model. J Affect Disord 2023; 342:157-165. [PMID: 37730148 DOI: 10.1016/j.jad.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 08/28/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Although previous findings with small samples indicated that sugar-sweetened beverages (SSB) consumption was associated with depressive symptoms in adolescents, the mediating effect of physical sub-health in the association is unknown. METHODS A survey was conducted among freshmen from 11 provinces in China. A food frequency questionnaire was used to collect dietary behavior, and patient health questionnaire-9 items was used to assess depressive symptoms. A generalized linear model was used to analyze the association between SSB consumption, physical sub-health and depressive symptoms. The structural equation model was used to analyze the mediating effect of physical sub-health. RESULTS Of the 31,856 participants, 36.5 % had positive depressive symptoms. After adjusting for variables, carbonate beverages (β = 0.11; 95%CI: 0.07-0.15; P = 0.000) and milk tea (β = 0.07; 95%CI: 0.01-0.13; P = 0.021) consumption was associated with depressive symptoms in boys. Carbonate beverages (β = 0.09; 95%CI: 0.05-0.13; P = 0.000), tea beverages (β = 0.09; 95%CI: 0.04-0.13; P = 0.000), and milk tea (β = 0.08; 95%CI: 0.04-0.11; P = 0.000) consumption was associated with depressive symptoms in girls. The mediating effect of physical sub-health accounted for 81.3 % of the total effect in the mediating model of SSB associated with depressive symptoms. LIMITATIONS Retrospective survey has certain information bias. Association observed in the cross-sectional study is uncertain. CONCLUSIONS The present study suggests that the consumption of SSB associated with depressive symptoms in Chinese college students, and physical sub-health plays a complete mediating role in the association.
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Affiliation(s)
- Honglv Xu
- School of Medicine, Kunming University, Kunming, Yunnan 650214, China; Community Nursing Research Team of Kunming University, Kunming, Yunnan 650214, China.
| | - Zhaoyu Yang
- School of Medicine, Kunming University, Kunming, Yunnan 650214, China; Campus hospital, Kunming University, Kunming, Yunnan 650214, China
| | - Dehui Liu
- Campus hospital, Kunming University, Kunming, Yunnan 650214, China
| | - Chunjie Yu
- Department of pharmacy, the first people's hospital of Kunming, Kunming, Yunnan 650100, China
| | - Yun Zhao
- Department of infection control, Yan'an Hospital of Kunming City, Kunming 650051, China
| | - Jiaxing Yang
- School of Medicine, Kunming University, Kunming, Yunnan 650214, China; Community Nursing Research Team of Kunming University, Kunming, Yunnan 650214, China
| | - Yingzhen Su
- School of Medicine, Kunming University, Kunming, Yunnan 650214, China; Community Nursing Research Team of Kunming University, Kunming, Yunnan 650214, China
| | - Yinghong Jiang
- School of Medicine, Kunming University, Kunming, Yunnan 650214, China; Community Nursing Research Team of Kunming University, Kunming, Yunnan 650214, China
| | - Qiuan Lu
- School of Medicine, Kunming University, Kunming, Yunnan 650214, China; Community Nursing Research Team of Kunming University, Kunming, Yunnan 650214, China
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50
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Liu Y, Lv B, Tang K, Qu H, Yu F, Shi Y. Si-Ni-San reverses dietary fat absorption defects in a murine model of depression. Biomed Pharmacother 2023; 168:115677. [PMID: 37857252 DOI: 10.1016/j.biopha.2023.115677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
Depression is often associated with fatigue/energy loss. However, we lack a detailed understanding of the factors explaining this association. In this study, we uncovered that depressed mice have a defect in fat absorption, resulting in weight loss and reduced circulating lipid levels. Si-Ni-San (SNS), a basic formula of traditional Chinese medicine (TCM) for the treatment of depression, was found to not only alleviate depression-like behaviors, but also reverse the weight loss and dietary fat absorption of depressed mice. We found that SNS improved body weight and circulating lipid levels of depressed mice by up-regulating proteins [such as FFA uptake protein (CD36), TAG synthesis proteins (GPAT3, MOGAT2, DGAT1 and DGAT2) and chylomicron packaging proteins (MTP and APOB)] in the fat absorption pathway. Furthermore, cell-based results conducted with LPS-stimulated mouse MODE-K and human Caco-2 cells support that SNS, as well as Sinensetin (SIN) and Nobiletin (NOB), the two active components of the formula, have a role in regulating lipid absorption. Mechanistic studies revealed that SNS reverses body weight and fat absorption defects of depressed mice in part through the NR1D1/BMAL1/DGAT2 axis. These findings advance our understanding of the crosstalk between depression and energy loss, highlight the importance of gut function in disease management, and provide a basis for the application of SNS in the clinical treatment of depression and related disorders.
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Affiliation(s)
- Yuanyuan Liu
- School of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Baojiang Lv
- School of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kanran Tang
- School of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haotian Qu
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fangjun Yu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Yafei Shi
- School of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, China.
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